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Basis of the Diagnosis and Feature of Scirrhous Gastric Cancer Terushige Yamamoto 1 , Ryuji Nagahama 1 , Hirotaka Nakashima 1 , Masayuki Suyama 1 , Misao Yoshida 1 , Yasuo Ohkura 2 , Naoko Watanabe 3 , Hayato Hirashima 3 , Akitoshi Miyamoto 4 1Foundation for Detection of Early Gastric Carcinoma, Tokyo 2Department of Pathology, Kyorin University School of Medicine, Tokyo 3Center for Gastroenterology, Aidu Chuo Hospital, Aizuwakamatsu, Japan 4Department of Gastroenterology, Yotsukaidou Tokushukai Medical Center, Yotsukaidou, Japan Keyword: スキルス胃癌 , linitis plastica型胃癌 pp.428-444
Published Date 2010/4/25
DOI https://doi.org/10.11477/mf.1403101880
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 We present cases of scirrhous gastric cancer to describe diagnostic evaluation of gastric wall distention demonstrated by upper GI series. Scirrhous cancer shows diffuse invasion of a broad range of submucosal tissues, and the consequent increase in fibrotic tissue leads to gastric wall induration, contraction, and stenosis. The characteristic features on upper GI series are luminal stenosis, marginal induration, poor extension, irregular curvature, and swollen, serpiginous, and curving folds with various transverse diameter or inconstant edges of space between folds. On the other hand, some cases with LP(linitis plastica)type scirrhous cancer show good extension and do not show the typical deformity, poor distension, or irregular folds on upper GI series, but only focal alterations even in the infiltrated area. Accurate observation of detailed mucosal findings is essential in the invaded area, such as unordered gastric small segment-like, granular shadow, or cracked-like structures.

 In cases with type IIc in the gastric fundic area, gastric wall distension should be modulated by controlling air inflation during x-ray study, attempting to depict subtle abnormal distension or duration, or pooling or of defective barium contrast, to interpret these mucosal manifestations.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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