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A Case of Widespread Ⅱc+Ⅱa Type Early Gastric Cancer H. Hidano 1 , S. Nakazawa 1 , M. Kajikawa 1 , Y. Tsukamoto 1 , S. Kawaguchi 1 , R. Hayakawa 2 12nd Dept. of Internal Medicine, Nagoya University School of Medicine 2Tomei Clinic of Gastroenterology pp.681-686
Published Date 1978/5/25
DOI https://doi.org/10.11477/mf.1403107318
  • Abstract
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 X-ray examination of a 76-year-old man, who had no past history or subjective symptoms that are applicable to the present disease, showed an elevated petal-like appearance of an edge-shaped curving series of wave crests which were found on the anterior wall of the antrum. In the double contrast study, polypoid lesions of various sizes and shapes were crowded together on the posterior wall from the lesser curvature of the upper corpus to the antrum. The presence of a IIc lesion which was adjacent to the polypoid lesion on the posterior wall of the corpus was faintly seen. The gastric wall of the lesion spread well.

 Endoseopy showed a discolored petal-like appearance of an edge-shaped curving series of wave crests on both the anterior and posterior wall of the antrum, and this appearance spread continuously to the anterior wall of the upper corpus. The IIc lesion was recognized as a red, shallow, depressed lesion in the posterior wall of the corpus, followed by the Ⅱa lesion described above. These X-ray and endoscopic findings led us to a diagnosis of widespread Ⅱc+Ⅱa type early gastric cancer.

 Microscopically the lesion was of rounded shape, measuring 8.0×8.0 cm, with a central erosion. The petal-like Ⅱa lesion occupied the entire anterior half and the posteroanal quarter of the lesion, and the adjacent Ⅱc lesion occupied the posteroanal quarter of the lesion. Histologically, this lesion consisted of a well differentiated adenocarcinoma. A study of lymph nodes showed no metastasis. These pathological findings indicated that this case was the typical Ⅱc+Ⅱa type early gastric cancer having the biphasic growth described by Sano.

 We correctly diagnosed this case of widespread Ⅱc+Ⅱa type early gastric cancer before operation.


Copyright © 1978, 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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