CLINICAL AND PATHOLOGICAL STUDIES OF MINUTE POLYPOID LESIONS OF THE COLON, BASED ON THE FINDINGS OF THE MAGNIFYING FIBER-COLONOSCOPY AND DISSECTING MICROSCOPY:FOCUSED ON MINUTE ADENOMAS

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• Magnifying fiber-colonoscopy reveals a pit pattern abnormality of colonic polypoid lesions through magnified obsergation. Even those mucosae that seem completely normal under ordinary observation sometimes turn into minute pit pattern abnormalities through magnified observation, and are consequently diagnosed through biopsy as adenoma or hyperplasia. However, biopsy of these minute abnormal pit patterns does not always permit an infallible histological diagnosis. If we could classify a series of pit pattern abnormalities in accordance with histological diagnosis, based on the findings available through the magnified observation, we might contribute enormously to the knowledge of a life history of the minute adenoma as well as its relation to colonic carcinoma. In order to obtain its histo-pathological verification, we made a comparative study of two groups by means of dissecting microscopy which enabled us a magnified observation of fixed materials of the colonic mucosa. The material in the control group was provided from 38 cases of administrative autopsy, and the investigated group was provided by 24 cases of the resected specimen of colonic carcinoma. A magnified observation by dissecting microscopy of the material, revealed a similar pit pattern abnormality as observed in vivo. We used these findings as a standard for further succesf ul exploration for minute ade-noma of less than lmm, or hyperplasia.Results: In the control group, we found 17 adenomas and 107 hyperplasias, while in the investi-gated group we found 32 adenomas and 36 hyperplasias. When the size of the polypoid lesion is over lmm, the incidence of adenoma increases in the inverse proportion to the hyperplasia. The incidence of adenoma in the control group was 34.2 per cent (13 cases out of 38 in total) and 45.8 per cent (11 cases out of 24 in total) in the carcinoma group.-4 Adenomas of less than lmm were detected in the control group (3 of the rectum and 1 of the sigmoid colon), while in the other group, 7 adenomas were found throughout the entire colon. Concerning the severity of atypia in the control group 94.1 per cent consisted of slight atypia, while the other showed 46.9 per cent of moderate to severe atypia. Ten adenomas less than 1mm in both groups cosisted of 8 with slight atypic and 2 with moderate atypia.

• 社団法人 日本消化器内視鏡学会の論文

社団法人 日本消化器内視鏡学会 | 論文

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