Two Cases of Mucosal Prolapse Syndrome-like Lesions with Colonic Diverticulosis

• Published in: Nippon Daicho Komonbyo Gakkai Zasshi Vol. 65; no. 4; pp. 209 - 213
• Main Authors: Sakata, Gentaro, Nozaki, Ryoichi, Sanefuji, Hayato, Ohwan, Tomohisa, Irie, Tomoko, Sato, Taichi, Fukami, Kensaku, Yamane, Keitaro, Nakamura, Yasushi, Tanaka, Masafumi, Takano, Shota, Fukunaga, Mitsuko, Saiki, Yasumitsu, Hisano, Saburo, Ogata, Shunji, Yamada, Kazutaka, Takano, Masahiro
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Coloproctology 2012
• ISSN: 0047-1801; 1882-9619
• DOI: 10.3862/jcoloproctology.65.209

Two cases of mucosal prolapse syndrome (MPS)-like lesions associated with colonic diverticulosis were treated in our hospital. The lesions were located in a region of the colon, where multiple diverticula were observed during long-term follow-up. Endoscopic findings showed poorly bordered, reddened and multiple submucosal tumor-like lesions. Pathological findings showed characteristic and pathognomonic fibromuscular obliteration, where upward extending smooth muscle fibers from the lamina muscularis mucosae were observed within the lamina propria. These findings were identical with those observed in rectal MPS. The present cases were accompanied with colonic adenoma or early colorectal carcinoma. Therefore, all the lesions including the neoplastic lesions were endoscopically resected simultaneously. Biopsy is useful to confirm final diagnosis of these lesions. In the case where differential diagnosis between MPS-like lesions and neoplastic lesions is exceptionally difficult, it is necessary to resect lesions endoscopically. Recently, the number of patients with colonic diverticulosis has been increasing in Japan, and at the same time, occurrences of MPS-like lesions are also expected to increase. Therefore, during an endoscopic examination in cases with multiple colonic diverticular lesions, it is necessary to bear those lesions in mind for the differential diagnosis.