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A Case of Villous Appearing Ⅰ+Ⅱc Type Early Gastric Cancer with Remarkable Protein Loss K. Hirose 1 , T. Osawa 1 , M. Kitagawa 2 , B. Murohisa 2 , Y. Muto 2 1Department of Radiology, Hamamatsu Medical Center 2Department of Gastroenterology, Hamamatsu Medical Center pp.1049-1054
Published Date 1978/8/25
DOI https://doi.org/10.11477/mf.1403107400
  • Abstract
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 This case is a 50-year-old woman with epigastric pain, edema on the face and extremities. Laboratory examinations on admission showed 2.8 g/dl~4.0 g/dl serum protein and 8.1% increased 131I-PVP excretion rate. X-ray and endoscopic examinations of the stomach revealed large villous appearing tumors from the angle to the pyloric antrum, which were suspected as advanced cancer. Since gastric biopsy indicated poorly differentiated adenocarcinoma, gastrectomy was done on Feb 23, 1977. Specimen of the resected stomach consisted of two large cauliflower-like soft tumors, measuring about 7 X 7 cm and 6 X 6 cm in diameters respectively, located over the posterior wall of the angle to the pyloric antrum. Histopathological diagnosis was Ⅰ+Ⅱc type early signet ring cell carcinoma and its infiltration was limited within sm layer.

 Gastric biopsy was done after 131I-PVP intravenous injection and then isotope counts were measured on the tissue of almost normal mucosa and that of tumors, to determine the protein losing area in the stomach. Isotope counts of the tissue from the villous appearing tumors were higher than those from the others. Computed analysis obtained from the resected stomach scanning by Gamma-Camera indicated higher isotope counts on the tumors areas than on the others. Diagnosis of the protein losing area made before operation agreed well with the result of resected stomach scanning. And then, we came to the conclusion that the hypoproteinemia of this patient was induced by protein loss from the surface of the villous appearing tumors in the stomach.


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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