具有低度和高度发育不良症的大型结直肠多体中的伪侵入性状毛囊
Gabriella Massarenti1, Marco R Novelli2, Cinzia Papadia3,4
1Internal Medicine, IRCCS University Hospital of Bologna Sant Orsola Polyclinic, Bologna, Bologna, Italy.
BMJ case reports
|August 14, 2025
概括
在接受结肠镜检查的患者身上发现了一种罕见的带分化的结肠直肠多. 准确的诊断和专家讨论对于管理这些息肉和预防癌症误诊至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
背景情况:
- 结肠直肠腺瘤可以呈现复杂的组织病理特征.
- 状斑块是结肠直肠腺瘤内的罕见良性病变,约在0.4%的病例中发生.
- 这些病变可以模仿恶性特征,造成诊断挑战.
研究的目的:
- 报告一个带有状块的大型结直肠腺瘤的病例.
- 突出诊断挑战和准确的病原体学评估的重要性.
- 强调多学科团队 (MDT) 讨论在制定复杂多重症的后续计划中的作用.
主要方法:
- 对患有腹部不适和肠癌家族病史的患者进行结肠镜检查.
- 大型上升结肠腺瘤 (35毫米) 的内镜粘膜切除 (EMR).
- 组织病理学检查显示低度和焦点高度发育不良与状分化和伪侵袭.
主要成果:
- 完全内镜切除腺瘤.
- 组织病理学证实了状分子,这是一个罕见的发现.
- 该案需要进行复杂的多MDT讨论,以制定适当的后续战略.
结论:
- 结肠直肠腺瘤中的状分子需要准确的诊断,以避免被误解为侵入性腺癌.
- 尽管它们的良性性质,状块可能表明腺瘤复发的风险更高.
- 跨学科的合作对于准确的诊断和最优的管理复杂的结直肠多体是必不可少的.
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