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A Case of Multiple Lesions, an Advanced Cancer and 3 Atypical Epitheliums, of the Stomach Y. Haraguchi 1 , T. Shiizaki 1 , K. Wakasugi 1 , H. Kiyonari 2 1Dept. of Gastroenterology, Sawara Hospital 2Kyushu Caszcer Center Hospital pp.65-71
Published Date 1976/1/25
DOI https://doi.org/10.11477/mf.1403107072
  • Abstract
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 Case: A 74-year-old male.

 X-ray revealed three independent lesions. The first was an irregularly-outlined nodular protrusion with slightly depressed surface located on the lesser curvature just above the gastric angle; the second was composed of granular mucosal changes uneven in size and shape, situated at the antrum just anal side from the gastric angle ; the third, a small polypoid lesion on the mid portion of the corpus.

 Endoscopy also revealed three independent lesions. The first was a nodular protrusion with depressed surface irregular in shape and uneven in base on the lesser curvature above the angle : the second was a plateau-like lesion with granular surface on the posterior wall of the antrum ; and the third, a small hemispherical lesion on the anterior wall in the midportion of the corpus.

 The gross specimen of the resected stomach are summarized as follows.

 1. An irregularly-outlined slightly elevated lesion, 2.5×1.4 cm in size, with partly eroded surface on the lesser curvature of the junctional zone.

 2. A plateau-like lesion with granular surface, 2.5×4.5 cm in size, in the posterior wall of the antrum and junctional area.

 3. A pedunculated polyp, measuring 1.0×0.7 cm with lobulated surface originating in the anterior wall of the body.

 4. Two adjacent depressed lesions, each 1.0×1.0 cm in size, partly accompanied by low protrusions with gyrus-like surface on the lesser curvature of the antrum. This lesion could not be pointed out preoperatively.

 Histologically, the lesion 1 was signet-ring cell carcinoma partly invading the muscularis propria. The lesion 2 was an adenoma of severe atypical epithelium with some suspicion of well-differentiated adenocarcinoma. The lesion 3 was an adenomatous polyp with slight atypicality and the lesion 4 was adenoma with moderate atypicality.

 In aged persons, coexistence of multiple lesions of the stomach is common; therefore, it is of great importance to check up on the entire stomach in diagnostic process.


Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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