Radiodiagnostic Possibility of Gastric Carcinoma Involving the Proper Muscle Layer M. Maruyama 1 , N. Sugiyama 1 , Y. Baba 1 , K. Nakamura 3 , K. Kumakura 4 1Department of Internal Medicine, Cancer Institute Hospital pp.855-868
Published Date 1976/7/25
DOI https://doi.org/10.11477/mf.1403107329
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 Radiodiagnostic possibility of gastric carcinoma involving the proper muscle layer (pm-carcinoma) was studied, based on 110 cases of such carcinoma and 54 cases of early carcinoma involving the submucosa which had been experienced for 9 years from 1966 to 1974 at the Cancer Institute Hospital. The following results were obtained.

 1) The radiological diagnosis of pm-carcinoma which was classified into the Borrmann's variety macroscopically should be discussed differently from that classified into the variety simulating early carcinoma (mostly IIc-simulating pm-carcinoma). 2) The radiological diagnosis of the IIc-simulating pm-carcinoma by compression images was studied, based on the analysis of invasion pattern of carcinoma in the submucosa and its continuity to the proper muscle layer. 3) An extensive involvement of the submucosa and the proper muscle layer produced marked surrounding translucency on the compression images of IIc simulating pm-carcinoma. The double contrast radiography proved to be ineffective for delineating surrounding translucency that might be caused by difference in the thickness of the gastric wall between the cancerous lesion and the adjacent normal portion. 4) In the cases of IIc-simulating pm-carcinoma which revealed slight or no surrounding translucency on the compression images, involvement of the proper muscle layer could not be identified, and in most cases the histological examination revealed that the submucosa as well as the proper muscle layer was involved slightly. 5) In the radiological estimation of invasion pattern of the IIc-simulating pm-cacinoma, it was not necessary to take acidity of gastric juice into consideration. 6) In the radiological diagnosis of the pm-carcinoma showing the Borrmann's variety on the compression images, deeper involvement beyond the proper muscle layer should always be considered.

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