鳥肌胃炎を伴う若年者の未分化型進行胃癌の1例

An Advanced Gastric Cancer of Undifferentiated Type with Nodular Gastritis, Report of a Case

要旨　患者は25歳，女性．心窩部痛を主訴に近医を受診し，前庭部前壁に進行胃癌を指摘され，加療目的で当院に紹介となった．当院外科で幽門側胃切除術（D2郭清）を施行された．病理診断はType 3，33×30mm，por2-sig＞muc，T3（SS），N0，Stage IIAであった．術後補助化学療法は行わず，外来で経過観察中で，現在まで再発は認めていない．若年者の胃癌は頻度が低いが，未分化型の腺癌がほとんどである．また，鳥肌胃炎はまれな病態であるが若年女性に多く，胃癌の高危険病変とされている．

　A 25-years-old woman was referred to our hospital from a clinician for treatment of advanced gastric adenocarcinoma. Esophago-gastro-duodenoscopy revealed an irregular ulcerative（Type 3）tumorin the anterior wall of the antrum. Evidence of nodular gastritis was found in the background mucosa. Distal gastrectomy with lymph node dissection was carried out. The tumor size was 33×30mm and histological examination of the resected specimen showed poorly differentiated adenocarcinoma invading the subserosa. No lymph node or peritoneal metastasis was found. Incidence of undifferentiated type gastric cancer is more common than that of differentiated type cancer in the younger population. Nodular gastritis is recently regarded as a specific subtype of Helicobacter pylori gastritis and as having potential risk for developing undifferentiated gastric cancer.