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The Widespread Gastric Erosion like Ⅱc Type (of Early Gastric Cancer) Accompanied with the Scar of Benign Gastric Ulcer (Ul-Ⅱ): Report of a case M. Nakano 1 , T. Onishi 2 , S. Inamori 2 , K. Nishii 3 , K. Kobayashi 4 1The Gastroenterology Center, Municipal Ise-Sogo Hospital 2Department of Surgery, Municipal Ise-Sogo Hospital 3Department of Surgery, Mie Prefectural Ichishi Hospital 4Department of Radiology, Kyorin University School of Medicine pp.1061-1066
Published Date 1978/8/25
DOI https://doi.org/10.11477/mf.1403107402
  • Abstract
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 A 61-year-old woman, who had been treated by steroid for rheumatoid arthritis for a long time, com plained of epigastric discomfort. The X-ray examination of the stomach revealed a shallow depressive lesion of uneven edge with converging folds and marginal elevation on the anterior wall near the lesser curvature at the prepyloric region. The gastroscopic examination demonstrated also the depressive lesion with marginal elevation. Numerous bleeding spots and islet-like prominences were observed on the surface of the lesion. The biopsy specimens were not malignant. The gastroscopic impression was Ⅱc type of early career or malignant lymphoma. Partial gastrectomy was then performed.

 Gross inspection of the resected stomach showed a depressive lesion, 20 X 25 mm, like Ⅱc type of early cancer on the anterior wall near the lesser curvature at the prepyloric region. The surface of the lesion was smooth and one of the converging folds was abnormally widened, but not slender.

 The histopathological findings revealed healed ulcer (Ul-Ⅱ stage) accompanied with interruption of muscularis mucosae. The pathogenesis of this case was presumed to be the long term steroid administration, but this erosion was not a typical steroid induced ulcer. If the gastric erosion like this case had been observed endoscopically for the period from genesis to healing, it might have been diagnosed as Ⅱc type of early cancer or a single widespread benign erosion. Careful follow-up study and repeated endoscopic biopsies are extremely important for these gastric lesions. Especially we would like to emphasize the importance of the above mentioned follow-up study and examinations. We have to concentrate our efforts on them in order to arrive at a diagnosis correctly.


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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