内容紹介
Summary
The patient, a woman in her 70s, was diagnosed with occlusive ileus caused by sigmoid colon cancer. She underwent transanal stent placement to release the occlusion. Subsequent detailed testing revealed a 70×60 mm mass on the dorsal side of the pancreas and PET-CT indicated an SUVmax 18.2 FDG uptake. EUS-FNA was performed twice. However, the mass was unable to be definitively diagnosed. The patient was then referred to our hospital. She underwent laparoscopic sigmoid colectomy and laparoscopic biopsy of the mass for sigmoid colon cancer. The patient progressed well postoperatively and was discharged home on postoperative day 9. The postoperative diagnosis was colon cancer(S, Type 2, 58×50 mm, tub2, pT4a[SE], pN1, Stage Ⅲa)and the biopsied mass was found to be a nodal marginal zone B-cell lymphoma according to histopathological testing. After undergoing chemotherapy at our hematology department, she has experienced no recurrence.
要旨
症例は70歳台,女性。前医で閉塞大腸癌に対して,経肛門的ステント留置術を施行された。CT検査で膵背側に70 mm大の腫瘤を認めた。EUS-FNAを2回施行されていたが,確定診断には至らなかった。転居に伴い当院へ紹介となった。当院でS状結腸癌,悪性リンパ腫疑いに対して,腹腔鏡下にS状結腸切除と腫瘤生検を同時に施行した。膵背側の腫瘤は病理組織学的検査でnodal marginal zone B-cell lymphomaの診断に至った。当院血液内科で化学療法施行後,無再発生存中である。
目次
The patient, a woman in her 70s, was diagnosed with occlusive ileus caused by sigmoid colon cancer. She underwent transanal stent placement to release the occlusion. Subsequent detailed testing revealed a 70×60 mm mass on the dorsal side of the pancreas and PET-CT indicated an SUVmax 18.2 FDG uptake. EUS-FNA was performed twice. However, the mass was unable to be definitively diagnosed. The patient was then referred to our hospital. She underwent laparoscopic sigmoid colectomy and laparoscopic biopsy of the mass for sigmoid colon cancer. The patient progressed well postoperatively and was discharged home on postoperative day 9. The postoperative diagnosis was colon cancer(S, Type 2, 58×50 mm, tub2, pT4a[SE], pN1, Stage Ⅲa)and the biopsied mass was found to be a nodal marginal zone B-cell lymphoma according to histopathological testing. After undergoing chemotherapy at our hematology department, she has experienced no recurrence.
要旨
症例は70歳台,女性。前医で閉塞大腸癌に対して,経肛門的ステント留置術を施行された。CT検査で膵背側に70 mm大の腫瘤を認めた。EUS-FNAを2回施行されていたが,確定診断には至らなかった。転居に伴い当院へ紹介となった。当院でS状結腸癌,悪性リンパ腫疑いに対して,腹腔鏡下にS状結腸切除と腫瘤生検を同時に施行した。膵背側の腫瘤は病理組織学的検査でnodal marginal zone B-cell lymphomaの診断に至った。当院血液内科で化学療法施行後,無再発生存中である。