학술논문

A Case of Rectal Endometriosis with Regional Lymph Node Involvement / 所属リンパ節にも内膜組織を認めた直腸子宮内膜症の1例
Document Type
Journal Article
Source
日本臨床外科学会雑誌 / Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 2013, 74(5):1326
Subject
intestinal endometriosis
lymph node involvement
rectum
リンパ節
直腸
腸管子宮内膜症
Language
Japanese
ISSN
1345-2843
1882-5133
Abstract
Intestinal endometriosis is a benign disorder characterized by the ectopic growth of endometrial tissue in the intestinal wall, causing various clinical symptoms. However, endometriosis may develop into precancerous lesions due to its neoplastic nature. We report a surgical case of rectal endometriosis in which endometrial tissue was present in the regional lymph nodes as well. The relevant literature is also reviewed.The patient was a 44-year-old woman with the chief complaints of a feeling of abdominal distension and abdominal pain. Sigmoidoscopy revealed clustered papillary polyps associated with stenosis of the rectosigmoid lumen. A biopsy suggested regenerative lesions without findings of malignancy. CT scans showed the circumferentially thickened rectosigmoid wall as well as marked dilatation of the proximal colon. Based on these findings, intestinal obstruction caused by rectal tumors was strongly suspected, though not definitively diagnosed, and low anterior resection with lymph node dissection was performed. Histopathology revealed glands, similar to endometrial glands in the proliferative stage, in the submucosa, muscularis propria, and subserosa. Intestinal endometriosis was thus diagnosed. The glandular structure was also present in the regional lymph nodes.