広範に表層拡大したⅡc型早期胃癌の1例

Superficially Spreading Ⅱc Type of Early Gastric Cancer, Report of a Case

要旨　患者は55歳，女性．検診の上部消化管X線検査で異常を指摘，内視鏡検査で早期胃癌と診断されて，治療目的で当院を受診した．入院後の胃X線検査および内視鏡検査では，胃体部から胃角部の前壁を中心に広範囲に浅い陥凹が拡がっており，生検で低分化腺癌を認めたため，表層拡大型のⅡcと診断され胃全摘術が施行された．切除胃肉眼標本では，胃角部を中心に体中部から幽門部の前後壁に拡がる9.5×83cm（ピンで固定後は10.0×9.2cm）の浅い陥凹が認められた．陥凹の境界は比較的明瞭で，陥凹底はやや白色調を呈し，また中央部に短い線状の潰瘍瘢痕を伴っていた．病理組織学的所見は，印環細胞癌で深達度はmであった．

　A 55-year-old female was admitted to our hospital because of gastric cancer which was picked up during a mass survey and diagnosed histologically with endoscopic biopsy. Radiological and endoscopic examination revealed superficial spreading type of early gastric cancer (Ⅱc type) and total gastrectomy was performed. Macroscopically, a shallow depressive lesion (10.0×9.2 cm) had spread widely in the anterior wall to the lesser curvature of the gastric body and pylorus. Pathological studies on the resected specimen revealed signet-ring cell carcinoma confined to the mucosal layer without lymph node metastasis.