3. Pathological Study of Rectal Carcinoma:On Retrograde Spread of Rectal Carcinoma in Rectal Wall
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The present study was made to determine the area to be resected in curative resection of rectal carcinoma rectum by means of pathologic examination of 85 resected materials of rectal carcinoma.<BR>1. A carcinoma lesion of the rectum enlarges in the lamina propria by means of displacing the surrounding tissue, and after it has broken through the lamina muscularis mucosa, it grows markedly in a swelling manner in th submucosa, to often evert the lamina muscularis, mucosa. The proper muscular layer forms a sort of barrier. against the growth of the carcinoma ; a lesion involvig the tissue outside the rectal wall is associated with hypertrophy and disruption of muscle layers, and also with a further marked eversion of the lamina muscularis mucosa.<BR>2. The rectal carcinoma mainly show papillotubular adenocarcinomas, but those involving deeper parts beyond the proper muscular layer often assume a tubular shape.<BR>3. The intramural growth of carcinoma takes place in the manner that the carcinoma often markedly enlarges in the submucosa, and that it often enlarges in a swelling or sprouting manner at its foremost end.<BR>4. The retrograde intramural spreading of rectal carcinoma, measuring not less than 0.5 cm, was observed in 21.2 % of the examined materials, and all the examined carcinoma but one measured not more than 2.5 cm. There was no difference in the degree of intramural development between the oral and the anal side.<BR>5. Many carcinomas presenting the retrograde intramural spreading are grossly classed to the intermediary and invasvie types, and histologically to the poorly differentiated adenocarcinoma, very frequently associated with cellular and structual atypism, invasion of blood vessels, and metastasis to lymph nodes. From the results of the above-mentioned study, a distanse of 3 cm between the lower margin of carcinoma and the resecting part is mostly sufficient, but the carcinomas involving as deep as the perirectal tissue, presenting severe cellular and structual atypism, and being of the poorly differentiated, invasive type should be resected not less than 6 cm from their lower margins.
- 日本大腸肛門病学会の論文
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- 3. Pathological Study of Rectal Carcinoma:On Retrograde Spread of Rectal Carcinoma in Rectal Wall
- Pathological Study of Rectal Carcinoma:On Cellular Atypism of Rectal Carcinoma