PMC3617975_01
Colonoscopy findings. a An elevated submucosal tumor is observed in the sigmoid colon. b After indigo carmine irrigation. There is no central depression on the tumor surface, which is covered with normal mucosa.
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F1
The tumor was suggestive of lymphangioma of the colon; therefore a snare polypectomy was performed (fig. 1).
Microscopic examination. a Lymphoid follicle formation is observed in the cancer cell nest circumference (HE, loupe). b An infiltrative growth suggestive of moderately to poorly differentiated adenocarcinoma is observed in the submucosa (HE, x4).
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F2
The resected specimen was a submucosal tumor measuring 2 x 5 x 3 mm, and an infiltrative growth suggestive of moderately to poorly differentiated adenocarcinoma was observed in the submucosa (fig. 2b). Lymphoid follicle formation with a germinal center was recognized in the circumference of the cancer cell nests (fig. 2a).
D2-40 staining reveals a cancer cell nest in the lymphatic vessel (x20).
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F3
INFb, ly2, v0, HM0, VM0, and budding, and it was grade 1 with positive staining for D2-40 (fig. 3). Immunostaining was negative for CK7 and weakly positive for CK20, which is consistent with the characteristics of colorectal carcinomas.