내시경집담회. EndoTODAY 이준행

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EndoTODAY 내시경 교실

[Thursday Endoscopy Conference 20180510. 송병근 선생님]

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1. Rectal carcinoid with lymph node metastasis

Rectal carcinoid로 의뢰된 환자입니다.

ESD가 시행되었고 병리소견에서 lymphatic invasion이 의심되었습니다.

Well differentiated neuroendocrine tumor (CARCINOID) (G1)
1) size: 1.2x1.0 cm
2) confined to mucosa and submucosa
3) mitosis: 1/10 HPF
4) lymphovascular invasion: suspicious (in one focus)
5) perineural invasion: absent
6) focal involvement of deep cauterized resection margin

수술을 시행하였고 아래의 결과였습니다.

Rectum, low anterior resection : Status post endoscopic submucosal dissection for well-differentiated neuroendocrine tumor
. No residual tumor
. Histologic type and grade: not identified (no residual tumor):
1. Location: rectum
2. Gross type: scar
3. Size: cannot be determined (no residual tumor)
4. Depth of invasion: cannot be determined (no residual tumor)
5. Resection margin: free from carcinoma (no residual tumor) safety margin: proximal, 9.2 cm; distal, 0.5 cm; circumferential (radial), >10 mm
6. Lymphovascular invasion: cannot be determined (no residual tumor)
7. Perineural invasion: cannot be determined (no residual tumor)
8. Regional lymph node metastasis: metastasis to 1 out of 12 regional lymph nodes (1/12: perirectal, 1/12)

직장 유암종 내시경 치료에서는 병리과 선생님이 매우 매우 매우 매우 중요합니다.

[References]

1) SMC Endoscopy Unit 삼성서울병원 내시경실

2) SMC Monday GI conference 삼성서울병원 일원내시경교실 월요점심소화기집담회

3) SMC Thursday endoscopy conference 삼성서울병원 일원내시경교실 목요점심내시경집담회