Carcinoma in villous adenoma of ascending colon associated with sarcoid reaction in the regional lymph nodes

A 79-year-old woman was admitted to our hospital due to continuous anal ble eding. Colonoscopy showed a huge villous tumor on the middle area of the as cending colon. A typical right colectomy and lymph node dissection were per formed. The resected specimen showed a villous type tumor located on the as cending colon. The histopathologic investigation demonstrated a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma and extend ing to the submucosa. Although there was no evidence of metastatic carcinom a in the dissected lymph nodes, epithelioid cell granulomas with multinucle ated giant cells lacking in the central caseous necrosis suggested sarcoid reaction.