PMC3618050_01
a Diffuse edema and a markedly erythematous elevated lesion extending from the end of the ileum to the rectum. b Diffusely edematous and markedly erythematous elevated lesions involved the entire colon and an elevated tumor, 30 x 35 mm, in the sigmoid colon were detected. c Polyps were no longer visible, though erythema and petechiae persisted, reflecting diversion colitis. d Five years after the operation and three years after H. pylori eradication, the CCS lesion had completely disappeared from the colon.
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F1
At our hospital, colonoscopy demonstrated diffuse edema and a markedly erythematous elevated lesion from the end of the ileum to the rectum (fig. 1a). At the second colonoscopy, an elevated tumor 30 x 35 mm was observed in the sigmoid colon (fig. 1b). On the other hand, on colonoscopy 2 years later, while polyps were no longer visible, erythema and petechiae persisted, reflecting diversion colitis (fig. 1c). After 2 further years, colonoscopy and upper gastrointestinal endoscopy showed normal findings (fig. 1d).
Salmon roe-like multiple elevated lesions with marked erythema involving almost the entire stomach (a) and edematous mucosa in the antrum (b) are shown. c Upper gastrointestinal endoscopy confirmed the absence of gastric polyps. d Four months after H. pylori eradication, the endoscopically demonstrated gastritis had improved and active inflammation had disappeared.
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F2
Upper gastrointestinal endoscopy showed salmon roe-like multiple elevated lesions with marked erythema involving almost the entire stomach (fig. 2a) and there was edematous mucosa in the antrum (fig. 2b), similar to that in the colon, as well as similar mild polypoid lesions in the duodenum. Upper gastrointestinal endoscopy confirmed the absence of gastric polyps or other abnormal findings in the duodenum (fig. 2c). After 4 months, the endoscopic and histological findings of gastritis had also improved and active inflammation had disappeared (fig. 2d).
a Initial pathological findings included edema and thickening of the colonic mucosa and crypts with cystic dilatation in the colon. b Histological examination revealed cystic dilatation of glands and edema, associated with well-differentiated adenocarcinoma and tubular adenoma in the sigmoid colon. c Five years after the initial operation, histological examination showed that not only the CCS lesions but also the diversion colitis findings had completely disappeared (H&E staining).
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F3
Initial pathological findings showed non-specific chronic inflammatory cell infiltration, edema and thickening of the colonic mucosa and crypts with cystic dilatation in the intestine (fig. 3a). CCS associated with sigmoid colon cancer (0-1, pM N0 M0) with tubular adenoma was thus diagnosed (fig. 3b). Histological examination showed no CCS lesions and no diversion colitis findings (fig. 3c).