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[다양한 대장 질환 - refractory UC 환자에서 total colectomy 후 진단된 직장암]

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수술전 조직검사에서는 한번은 adenoma, inflammed granulation tissue로 다른 한번은 chronic active inflammation (1) cryptitis and crypt distortion, (2) inflammed granulation tissue로 나왔습니다. Steroid로 증상 조절이 되지 않는 점도 함께 고려하여 total colectomy를 하였는데 암으로 나왔습니다.

Rectum, colon, cecum, appendix, and terminal ileum, total proctocolectomy
Adenocarcinoma, moderately differentiated:
1. Location: rectum
2. Gross type: ulceroinfiltrative
3. Size: 4.5x4 cm
4. Depth of invasion: invades perirectal adipose tissue(pT3)
5. Resection margin: free from carcinoma, safety margin: proximal, 76cm ; distal, 4cm
6. Regional lymph node metastasis : no metastasis in all 103 regional lymph nodes (pN0), (0/103: pericolic & perirectal, 0/102; inferior mesenteric artery root, 0/1)
7. Lymphatic invasion: present
8. Venous invasion: not identified
9. Neural invasion: present
10. Tumor budding : negative
11. Associated findings : ulcerative colitis with total involvement of resected specimen

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2015-10-8)