Radiation Oncology, Chulolongkorn University : Pathology

Radiation Oncology Chulolongkorn University

Pathology

ÅÑ¡É³Ð¾ÂÒ¸ÔÊÀÒ¾¢Í§ÁÐàÃç§ÅÓäÊéãËèÊÒÁÒÃ¶áºè§ä´éµÒÁÅÑ¡É³Ð¢Í§¡éÍ¹ÁÐàÃç§ÁÍ§àËç¹à»ç¹ 4 ÅÑ¡É³Ð(9)
1. Fungating (Exophytic) ÅÑ¡É³Ð¹Õé¨ÐàËç¹à»ç¹¡éÍ¹Â×è¹ÍÍ¡¨Ò¡¼ÔÇàÂ×èÍºØÅÓäÊéãËèà¢éÒä»ã¹ Lumen áÅÐÁÑ¡¨Ð¾ºÍÂÙè´éÒ¹ã´´éÒ¹Ë¹Öè§¢Í§¼¹Ñ§ÅÓäÊéãËè ÊèÇ¹ãËè¨Ð¾º¡éÍ¹ÁÐàÃç§áºº¹Õé·Õè Cecum ËÃ×Í Ascending Colon ¾ºÇèÒÁÐàÃç§ÅÓäÊéãËè»ÃÐÁÒ³Ë¹Öè§ã¹ÊÒÁ¨Ðà»ç¹áºº Fungating
2. Ulcerating ¡éÍ¹ÁÐàÃç§¨ÐÁÕÅÑ¡É³ÐàËÁ×Í¹à»ç¹á¼Å (Ulcer) ·Õè¼ÔÇáÅÐÁÑ¡¨ÐÁÕàÅ×Í´ÍÍ¡¨Ò¡ ¡éÍ¹ÁÐàÃç§ä´é§èÒÂ ·ÓãËé¼Ùé»èÇÂÁÒËÒá¾·Âì´éÇÂÍÒ¡ÒÃÍØ¨¨ÒÃÐà»ç¹àÅ×Í´ËÃ×ÍµÃÇ¨¾º¼ÅºÇ¡¢Í§
Stool Occult Blood ¾ºÇèÒÊÍ§ã¹ÊÒÁ¢Í§ÁÐàÃç§ÅÓäÊéãËè¨ÐÁÕÅÑ¡É³Ðáºº¹Õé
3. Stenosing ºÒ§¤ÃÑé§¡éÍ¹ÁÐàÃç§¨Ðà¨ÃÔàµÔºâµà¢éÒä»ã¹ Lumen ¢Í§ÅÓäÊéãËè¨¹·ÓãËé·Ò§à´Ô¹ÅÓäÊéá¤ºµÕºµÑ¹
4. Constricting (Annular and Circumferential) à»ç¹ÅÑ¡É³Ð¢Í§¡éÍ¹ÁÐàÃç§·Õèâµä»µÒÁ¼¹Ñ§¢Í§ÅÓäÊéãËè¨¹ÃÍº Lumen à¡Ô´ÅÑ¡É³Ðà©¾ÒÐ·ÕèàÃÕÂ¡ÇèÒ Napkin-ring ·ÕèàËç¹ã¹ Barium Enema «Öè§ÁÑ¡¨Ð¾ºã¹ÁÐàÃç§·Õèà¡Ô´·Ò§´éÒ¹«éÒÂ¢Í§ÅÓäÊéãËè (Left-sided Colon Cancer) ·ÓãËéà¡Ô´¡ÒÃÍØ´µÑ¹¢Í§ÅÓäÊéãËè àª×èÍÇèÒà¡Ô´¢Öé¹¨Ò¡¡ÒÃ·Õèà«ÅÅìÁÐàÃç§á¾Ãè¡ÃÐ¨ÒÂä»µÒÁ Circumferential Lymphatics10

World Health Organization (WHO) ä´éáºè§ÁÐàÃç§ÅÓäÊéãËèÍÍ¡à»ç¹ 5 ¡ÅØèÁãËè æ 11
´Ñ§µèÍä»¹Õé
1. Epithelial Tumors
Adenocarcinoma
Mucinous Adenocarcinoma
Signet-ring Carcinoma
Squamous Cell Carcinoma
Adenosquamous Carcinoma
Undifferentiated Carcinoma
Unclassified carcinoma
2. Carcinoid Tumors
Argentaffin
Nonargentaffin
Composite
3. Nonepithelial Tumors
Leiomyosarcoma
Others
4. Hematopoietic and Lymphoid Neoplasms
5. Unclassified
90-95% ¢Í§¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËèÁÕ¾ÂÒ¸ÔÊÀÒ¾áºº Adenocarcinoma12,13 ÊÍ§ã¹ÊÒÁ¢Í§ÁÐàÃç§ÅÓäÊéãËèÍÂÙè·Õè Rectum, Rectosigmoid ËÃ×Í Sigmoid Colon14 ÊÓËÃÑº¾ÂÒ¸ÔÊÀÒ¾ª¹Ô´ Mucinous ËÃ×Í Colloid Adenocarcinoma ¾ºä´é»ÃÐÁÒ³ 17%15 áÅÐÁÕÅÑ¡É³Ð·ÕèÊÓ¤Ñ ¤×Í»ÃÐ¡Íº´éÇÂ Extracellular Mucin ÊèÇ¹ª¹Ô´ Signet-ring Cell Adenocarcinoma ¾º»ÃÐÁÒ³
2-4% «Öè§»ÃÐ¡Íº´éÇÂÅÑ¡É³Ð¢Í§ Intracellular Mucin «Öè§´Ñ¹ Nucleus ä»ÍÕ¡´éÒ¹Ë¹Öè§16 Squamous Cell Carcinoma ¢Í§ÅÓäÊéãËè¾º¹éÍÂÁÒ¡ ÁÕÃÒÂ§Ò¹à¾ÕÂ§ 40 ÃÒÂ·ÑèÇâÅ¡à·èÒ¹Ñé¹17 ºÒ§¤ÃÑé§ÍÒ¨¾ºÅÑ¡É³Ð·Õè¼ÊÁ¡Ñ¹ÃÐËÇèÒ§ Squamous Cell Carcinoma áÅÐ Adenocarcinoma àÃÕÂ¡ÇèÒ Adenosquamous Carcinoma ËÃ×Í Adenocanthomas13 ÊÓËÃÑº Undifferentiated Carcinoma ¨ÐÁÕÅÑ¡É³Ð·ÕèÊÓ¤Ñ¤×ÍäÁèÁÕ Glandular Structures à¹×èÍ§¨Ò¡äÁèÁÕ¡ÒÃ Differentiate à»ç¹ Tubules áÅÐ
äÁè¤èÍÂÁÕ Nuclear Pleomorphism18
Carcinoid Tumors ¢Í§ÅÓäÊéãËè¾ºä´éÃÒÇ 4-17% ã¹ Rectum áÅÐ 2-7% ¢Í§ Colon19,20
ÁÑ¡¨ÐÁÕÅÑ¡É³Ðà»ç¹ Polypoid Nodules ·Õèá¢ç§áÅÐÁÕ¢¹Ò´àÅç¡»¡¤ÅØÁ´éÇÂ Mucosa áÅÐäÁè¤èÍÂ·ÓãËéà¡Ô´¡ÅØèÁÍÒ¡ÒÃ Carcinoid à¹×éÍ§Í¡ª¹Ô´¹ÕéÊÒÁÒÃ¶áºè§à»ç¹»ÃÐàÀ·ÂèÍÂµÒÁ¡ÒÃÂéÍÁ¾ÔàÈÉà»ç¹ Argentaffin Nonargentaffin ËÃ×Íà»ç¹ª¹Ô´ Composite
Sarcomas ¢Í§ÅÓäÊéãËè¾ºä´é¹éÍÂÁÒ¡ ¡ÅèÒÇ¤×Í¾ºà¾ÕÂ§ 0.1-0.3% ÁÑ¡¨Ð¾ºà»ç¹ Leiomyosarcoma(21,22,23) ÊèÇ¹¾ÂÒ¸ÔÊÀÒ¾Í×è¹ æ àªè¹ Malignant Non-Hodgkin’s Lymphoma(24,25)
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Last modified on 25 October 1996