胃底腺領域内の限局性萎縮を伴う小胃癌の1例

Gastric Cancer Associated with Localized Atrophy of Fundic Mucosa, Report of a Case

要旨　患者は39歳，女性．心窩部痛を主訴に来院した．上部内視鏡検査で，胃体中部大彎に限局性の褪色した陥凹を認めた．胃X線検査では同部位に浅い陥凹性病変を認めたが，アレア模様には異常がなかった．切除標本では潰瘍瘢痕は認めず，体中部大彎に52×23mmの陥凹性病変がみられた．病理組織学的には陥凹性病変の大部分は萎縮した胃粘膜で，後壁寄りに大きさ9mmの低分化腺癌を伴っていた．

　A 39-year-old female came to our hospital complaining of epigastric pain. X-ray and endoscopic examination revealed a shallow depressed lesion on the greater curvature of the mid-gastric body. In the lesion gastric folds gradually disappeared. Endoscopically the lesion corresponded to a discolored area on the same part of the stomach. Distal partial gastrectomy was undertaken. The resected specimen showed a shallow depression on the greater curvature of the mid-gastric body, 52×23 mm in size. Histologically, a small cancer focus (poorly differentiated adenocarcinoma, 9 mm in size) was detected on the posterior edge of the lesion. Histological examination also showed that most of the depressed area was atrophic gastric mucosa. Gastric cancer associated with localized atrophic fundic mucosa has not been previously reported.