Báo cáo ca lâm sàng: Hình thái nội soi của tổn thương răng cưa không cuống có loạn sản
Từ khóa:
Serrated sessile lesion, dysplasia, NBITóm tắt
Ung thư đại trực tràng xuất phát từ tổn thương răng cưa chiếm tỷ lệ 20–30%. Hơn nữa, ung thư biểu mô có nguồn gốc từ tổn thương răng cưa không cuống (SSL) có sự xâm lấn vào mạch bạch huyết và di căn hạch bạch huyết cao hơn so với ung thư biểu mô có nguồn gốc từ u tuyến. Tuy nhiên, SSL rất khó phát hiện. Do đó, SSL là một trong những nguyên nhân dẫn đến thất bại của nội soi đại tràng trong việc ngăn ngừa ung thư đại tràng phía gần. Vì vậy, việc nhận diện được đặc điểm hình thái SSL sẽ giúp cải thiện khả năng phát hiện SSL và tăng hiệu quả của nội soi đại tràng trong việc ngăn ngừa ung thư đại trực tràng. Chúng tôi mô tả ở đây trường hợp bệnh nhân nữ 76 tuổi được nội soi đại tràng phát hiện SSL ở đại tràng lên. Các đặc điểm của polyp bao gồm kích thước 20 mm, dạng bản cuống, lõm ở trung tâm, mủ nhầy trên bề mặt polyp, không có đường viền rõ ràng (trên nội soi ánh sáng trắng) và các tuyến dãn lớn, vi mạch máu dãn, bề mặt không đồng nhất (trên NBI phóng đại). Những đặc điểm này gợi ý chẩn đoán SSL có loạn sản.
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