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要旨 スキルス胃癌のEUS像の特徴は,壁肥厚とされている.壁肥厚を呈する症例として主なものは,Menetrier's disease,潰瘍瘢痕,悪性リンパ腫,迷入膵,梅毒,cytomegalovirus gastritisなどがある.これらの疾患は,主に粘膜,粘膜下層の肥厚がみられるが,スキルス胃癌では,胃壁全層,すなわち固有筋層まで肥厚が観察される.確定診断である生検診断は,肥厚が著しい部分の深部生検,EUS-FNAが有効とされている.
The feature of Scirrhous gastric cancer is thickening of the gastric wall.Differential diagnoses of diffuse large gastric folds are Menetrier's disease or hypertrophic gastritis, gastric ulcer or scar, Non Hodgkin lymphoma, rare cases of Abrant pancreas, Syphilis, Cytomegalovirous gastritis so on. These diseases involve thickening of the mucosa and the submucosa, However, Scirrhous type of gastric cancer is thickening of the whole gastric wall, especially in the proper muscle. In the final pathogical diagnosis it was difficult to get malignant cells in Scirrhous. cancer, but endoscopic ultrasonography-guided fine-needle cytology(EUS-FNA)and deep biopsy under EUS has been applied in achieving diagnosis of this tissue.
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