Histogenetic Backgrounds and Growth Pattern of Undifferentiated Type Microcarcinoma of the Stomach: In Comparison with Differentiated Type Microcarcinoma Akio Yanagisawa 1 , Yo Kato 1 , Haruo Sugano 1 1Department of Pathology, Cancer Institute pp.1335-1343
Published Date 1989/12/25
DOI https://doi.org/10.11477/mf.1403106633
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 To elucidate histogenetic backgrounds of undifferentiated type carcinoma (UCA) of the stomach, we investigated the incidence of intestinal metaplasia or pseudopyloric gland in the mucosae adjacent to (0-0.5 mm) and a few millimeter (2-3 mm) away from the microcarcinoma (carcinoma of 5 mm or less in the largest diameter, n=12) located in the fundic gland area. No significant difference in incidence of these changes was observed between the two separate mucosal sites around the carcinoma. When these UCA were classified into either signet ring cell type or poorly differentiated type, the lesion was surrounded by the fundic gland mucosae without intestinal metaplasia or pseudopyloric gland in all cases (n=7) of the former type, while it was accompanied by at least one of these mucosal changes in the cases of latter type. Hence, the histogenetic background of UCA should be considered separately for each subtype.

 Furthermore, observing gross appearance of microcarcinoma made it possible to investigate growth pattern of UCA in its very early phase in comparison with that of differentiated type carcinoma (DCA). Most (80.0%) of the UCA, particularly of signet ring cell type, were of flat type (Ⅱb) when the lesions were less than 3 mm. With the lesions 3 mm or more, the incidence of flat type fell to 28.6% and, instead, that of depressed type (Ⅱc) rose to as high as 71.4%. On the contrary, most of the DCA remained Ⅱc or Ⅱb throughout the stage of microcarcinoma. The elevated type was infrequent even among the cases with the lesion of 5 mm in size. Therefore, UCA in its very early stage seemed to grow more frequently in flat fashion than in depressed fashion compared to DCA.

 Discussion was also made regarding the relationship between histological change and growth pattern.

Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.


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