Open AccessSmall depressed lesion of the colon detected using image‐enhanced endoscopy: A case of adenocarcinoma of the lung with metastasis to the colon
Author(s) -
Lin ShihChun,
Chien HuiPing,
Lin YuMin
Publication year - 2021
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.13208
Subject(s) - medicine , adenocarcinoma , colonoscopy , lesion , lung , colorectal cancer , metastasis , pathology , transverse colon , ascending colon , biopsy , radiology , gastroenterology , cancer
Colonic metastasis from lung cancer is rare. The findings of metastatic lesion colonoscopies are variable, and such lesions usually have advanced features. Here, we report a case of a patient with lung adenocarcinoma metastasis to the colon presenting with chronic diarrhea. The patient underwent a colonoscopy, and a small depressed lesion was identified at the ascending colon. In narrow‐band imaging (NBI), the lesion appeared dark brown with an irregular and disrupted vascular pattern on the surface. An invasive tumor was suspected based on image‐enhanced endoscopy (IEE). The pathologic report revealed adenocarcinoma. Immunohistochemistry was positive for thyroid transcription factor 1 and negative for caudal‐related homeobox transcription factor 2 in colonic biopsy specimens. The diagnosis of adenocarcinoma of the lung with metastasis to the colon was confirmed. This case report presents surface images of metastatic lesions in the colon and highlights the role of NBI in predicting the invasiveness of depressed lesions. The application of IEE could be extended to the evaluation of not only primary but also metastatic lesions in the colon.