Carcinoma complicating ulcerative colitis.

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In patients with ulcerative colitis, complicated carcinomas tend to be multicentric, right-sided, flatly elevated without ulceration grossly, and less differentiated histologically. We confirmed the characteristics of complicated carcinoma by examining total colectomy material of a foreign male patient for advanced cancers of the ascending colon and rectum superimposing ulcerative colitis. Various histological features of dysplasia, together with carcinoma, were observed in our case and shown according to the classification by Riddel et al. We understood the concept and classification of dysplasia by Riddel et al., but we were not able to accept the opinion that even frank intramucosal carcinoma is included in high grade dysplasia. Mucin histochemistry and immunohistochemistry using lectin, carcinoembrionic antigen (CEA) and CA 19-9 was applied to the assessment of dysplasia observed in our case. Sialomucin was predominat in villous dysplasia and carcinoma. Positivity of CEA and CA 19-9 was confined to dysplasia and carcinoma but staining of CEA was more stable than that of CA 19-9. We concidered that CEA is useful diagnostic aid for dysplasia and carcinoma.
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