A case of Lymphoangioma of the Colon with Overlapping Tubular Adenoma.

DOI 1 Citations 16 References
  • SATO Yasushi
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • OKUDA Toshinori
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • TAKAYAMA Tetsuji
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • TAKIMOTO Rishu
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • SATO Tutomu
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • SAGAWA Tamotsu
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • AKIYAMA Takehide
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • SATO Yasuhiro
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • HAGIWARA Seiya
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • SATO Yoshimi
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • ONUMA Keisuke
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • ABE Tomoyuki
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • HONDA Kana
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • KATO Junji
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine
  • NIITSU Yoshiro
    Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine

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  • 腺腫を同一部位に合併した大腸リンパ管腫の１例

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Abstract

A 78-year-old male was admitted to our hospital for the evaluation of hypergammag-lobulinemia. He was diagnosed as having Monoclonal gammopathy of undetermined significance (MGUS), after the examinations. Barium enema and colonoscopy for surveillance to detect amyloidosis, related complication of the MUGS, revealed a 3.0cm × 3.0cm sized submucosal tumor (SMT) with positive cushion sign. Its mucosal surface was diffusely covered with slightly protruded, lobulated mucosa in the transverse colon. Tubular adenoma was detected from a biopsy specimen of overlaid lesion. Endoscopic ultrasonography (EUS) of the SMT demonstrated multiple anechoic, cyst-like patterns, located predominantly in the 3rd layer and thickening of the 1st 2nd layer on which lesion adenoma were overlayed. Based on these findings, they were thought to be colon lymphoangioma overlapping colonic adenoma as a preoperative diagnosis. Laparoscopic excision was performed and histopathologic evaluation of the resected specimen confirmed a tubular adenoma overlying a lymphoangioma. As endoscopic examination has become more widespread, colonic lymphoangioma have increasingly been reported. However, this case is considered an extremely rare case from reviewing literature, and EUS was thought to be very useful for the diagnosis of the lymphoangioma, even if colonic adenoma is overlying.

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