Radiography for Polypoid Early Cancer Tsutomu Hamada 1 , Kenji Kondo 1 , Yukie Itagaki 1 , Tsuguhiko Izumi 1 , Masanori Shitaya 1 1Department of Gastroenterology, Social Health Insurance Medical Center Keyword: 早期胃癌 , 隆起型癌 , X線診断 pp.47-56
Published Date 2000/1/25
DOI https://doi.org/10.11477/mf.1403104627
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 The macroscopic classification of polypoid early cancer includes three types; namely type I (protuded type), type Ⅱa (superficial, elevated type) and type Ⅱa+Ⅱc. In this paper, the basic radiographic findings were described in order to distinguish the three types from other polypoid lesions.

 (1) Type I cancers are characterized by a pedunculated or subpedunculated contour with marked protrusion into the gastric lumen, so it is easy to diagnose them either by a double contrast or a compression image. But, a polypoid tumor with a wide-base and with rigidity of the gastric wall on the radiographic lateral view is suggestive of advanced cancer.

 (2) Type Ⅱa is recognized by its having a flat elevation with a sessile profile form and in most cases of this type there is cancerous invasion limited to the mucosa with no relation to size. The granular surface pattern is characteristic of this type, but, it's hard to distinguish it from adenoma. The compression views on radiography usually give better pictures than double contrast views. In case of Ⅱa situated in the upper part of the stomach radiolucent shadow should be taken while observing the flow of the barium during the examination.

 (3) Most type Ⅱa+Ⅱc cancers are characterized by a central Ⅱc-like depression within the Type Ⅱa. Most cancers of this type easily invade to the submucosa even though they are less than 10 mm in size. Cancers with submucosal invasion become hard, so both the compression and the double contrast examination are reliable methods for delineating all their aspects.

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