A Case of So-called Superficial Spreading Type Early Gastric Cancer (grouped Ⅱa and Ⅱb-like Ⅱc) O. Takahara 1 , H. Takahara 2 , I. Yamashita 2 , K. Noguchi 3 1Institute of Atomic Radiation Effects, Japanese Red Cross, Nagasaki Atomic Bomb Hospital 2Takahara-tchûô Hospital 3Department of Surgery, Japanese Red Cross, Nagasaki Atomic Bomb Hospital pp.641-646
Published Date 1976/5/25
DOI https://doi.org/10.11477/mf.1403107262
  • Abstract
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 Case: 43-year-old female.

 She visited Takahara-tchûô Hospital with chief complaint of pain in the upper abdomen, and underwent an upper gastrointestinal tract series and endoscopic examination, which revealed many small protruded lesions on the mucosa of gastric angle and body.

 She underwent subtotal gastrectomy at Japanese Red Cross, Atomic Bomb Hospital.

 Pathological findings of the resected stomach: Grossly, it showed so-called superficial spreading type of carcinoma, extending from mid-body to angle of the stomach, with small irregular protruded lesions (grouped as Ⅱa), and shallow depression (Ⅱb-like Ⅱc) adjacent to the oral magin of the former.

 Histologically, there were intramucosal well differentiated tubular adenocarcinoma and poorly differentiated muco-cellular adenocarcinoma of the stomach, without metastases to lymphnodes.

 It was found by serial sections that many small cancerous glands were scattered superficially in the propria mucosa, adjacent to the carcinoma mass and fusing into one or several normal gastric glands. In this case, following points are interesting.

 1) Although this case is a middle-aged female, she has a well differentiated tubular adenocarcinoma of the stomach, which shows many small protruded lesion (grouped as Ⅱa).

 2) Gastric biopsy is useful for differential diagnosis, and for determining the extent of cancerous invasion.

 3) Dissemination of carcinoma cells in the superficial propria mucosae through interstitial space shows a possible mode of spreading of early gastric carcinoma.

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


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