Early colonic carcinoma with extensive lymph node metastases: case report and review of literature

An 81-year-old woman had an early carcinoma invading focally into the upper submucosa of the middle-transverse colon, which was accompanied by extensi ve lymph node metastases and resulted in a poor prognosis. Although her tum or was small and flat, a rim of pale yellow-speckled mucosa adjacent to the tumor enabled its earlier detection. To further study the exceptional lymp h node metastases we studied the expression of intestinal trefoil factor an d sialyl Tn antigen immunohistochemically on the resected specimen. Their s imultaneous expression in lymph node metastasis further supports the aggres sive nature of this tumor.