The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Pericolonic Metastasis in Recurrent Signet-Ring-Cell Adenocarcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Forward-Viewing Echoendoscope

직시 초음파내시경 유도 세침흡인으로 진단된 재발성 반지세포암

  • Nam, Kwang Woo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Moon, Min Young (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jin Seo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Won, Sung Hyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Dong Wan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Do Hyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 남광우 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 문민영 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이진서 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 원성현 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이상수 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 서동완 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 박도현 (울산대학교 의과대학 서울아산병원 내과학교실)
  • Received : 2013.02.01
  • Accepted : 2013.04.03
  • Published : 2014.02.01
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Abstract

Endoscopic ultrasound-guided fine-needle aspiration is used for the diagnosis and evaluation of rectal and pelvic lesions in lower gastrointestinal tract disease. However, it is not used widely in proximal and transverse colon disease because of the limited visual field and technical problems related to an oblique-viewing echoendoscope. Here, we report a case of recurrent signet-ring-cell gastric adenocarcinoma involving the transverse colon not diagnosed by repeated colonoscopic biopsies that was eventually diagnosed using a forward-viewing echoendoscope with fine-needle aspiration biopsy.

초음파내시경 유도 세침흡인 검사는 근위부 대장 병변에서 현재 잘 쓰이고 있지 않으며 이는 사시 초음파내시경으로는 병변으로의 접근이 쉽지 않기 때문이다. 본 증례에서는 횡행 결장을 침범한 반지세포 위선암의 재발이 의심되나 반복적인 대장내시경 조직 검사에서 악성세포가 확인되지 않았던 환자에서 직시 초음파내시경을 이용한 중심부바늘생검 검사로 악성세포를 확인할 수 있었다. 근위부 대장 병변에서 대장내시경 조직 검사로 적절한 진단이 어려운 경우에는 직시 초음파내시경 중심부바늘생검 검사가 진단에 유용할 것으로 생각한다.

Keywords

References

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