2個のⅠ型隆起型癌を有する3個の多発早期胃癌の1例

Triple Early Gastric Carcinomas Consisting of Two Lesions of Type Ⅰ and One Lesion of Type Ⅱc, Report of a Case

要旨　患者は73歳，男性．主訴は動悸，全身倦怠感．血液学的に中等度の正球性，正色素性貧血を認めた．上部消化管検索の結果，胃角部に31×20mm，10×7mmの2個のⅠ型早期胃癌が存在した．切除胃の病理組織学的検索で，これら2個のⅠ型隆起型癌は良性成分を含まず，ポリポイドに発育した癌と考えられた．また，Ⅰ型胃癌の口側に2mmの微小胃癌が認められた．周辺胃粘膜は不完全型腸上皮化生がびまん性に認められ，典型的な高齢者の胃癌であった．

　A 73-year-old man visited our hospital because of palpitation and general fatigue. Haematological examination revealed normocytic normochromic anemia. Upper gastrointestinal examination showed two elevated lesions of type I early gastric carcinomas (A and B in Fig. 5 b). Histopathologically, these protruding lesions lacked benign components and the muscularis mucosae looked the so-called Ω type in shape. These carcinomas seemed to have developed as polypoid carcinoma. The third minute carcinoma was found in the lower body of the stomach (lesion Cin Fig. 5 b). These lesions were surrounded by diffuse incomplete intestinal metaplasia. This is the typical case of gastric carcinoma in the elderly.