同一胃内に多数の多発胃癌病巣を認めた1例

Multiple Gastric Cancer, Report of a Case and Review of the Literature

要旨　21歳の男性の切除胃の組織学的検索により，1つの進行癌病巣以外に，胃粘膜の腺頸部層に限局した80か所以上の微小Ⅱb型の印環細胞癌から成る多発癌病巣を発見した．連続切片作製による検討から，各々の病巣は別個に存在し，主病巣近辺のみならず広く分布しており，それぞれ別個に発生したものと考えられた．このような多発胃癌は珍しく，癌の発生を考えるうえで興味ある1例と考えられた．

　A 21-year-old man with multiple gastric cancer underwent partial gastrectomy. Histological examination of the surgical specimen revealed an advanced gastric cancer and many small lesions of early gastric cancers (more than 80). The small cancer lesions were type Ⅱb according to the macroscopic classification, and cancer cells occupied the neck zone of the gastric gland. All of these lesions were composed of signetring cell carcinomas. Interestingly, examination of the serial sections showed that minute cancer lesions were separated from each other, and more than 80 lesions were recognized independently.

　These results suggest that each of these minute lesions occurred independently, and this fact offers an important interpretation of carcinogenesis of multiple gastrlc cancer