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Micro-adenocarcinoma of the Stomach Stemming from Atypical Epithelium, a Case Report K. Kitamura 1 , S. Nakano 1 , H. Watahiki 1 , I. Takeda 1 , I. Naito 2 1The 2nd Department of Internal Medicine, Ogaki Municipal Hospital 2Onoso Hospital pp.1205-1210
Published Date 1979/9/25
DOI https://doi.org/10.11477/mf.1403107761
  • Abstract
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 The patient, a 71-year-old man, had a complaint of sense of fullness in the abdomen. About two years before he had been diagnosed by his doctor to harbor protruding type of atypical epithelium of the stomach. In April 1978 we were asked to make thorough check-up for an indication of surgical exploration. Physical examination at admission showed only slight anemia in the palpebral conjunctiva. Laboratory examinations also showed slight anemia in the peripheral blood.

 X-ray and endoscopy of the stomach showed a clusther of low elevations of various size in a wide area extending from the lower corpus down to the antrum centering on the posterior wall in the angle area. The lesions called for strict discrimination between atypical epithelium and clustered Ⅱa type cancer. Because the surface of the elevations was relatively smooth with no erosion or reddening and no cancer cells were detected by biopsy, we arrived at a diagnosis of atypical epithelium of the stomach. However, since the lesion as a whole measured more than 2cm in diameter, we were unable to rule out the possibility of partial cancer nests. Gastrectomy was performed.

 Macroscopically a cluster of low elevations of varying size was recognized in an area measuring 55×30 mm centering on the posterior wall of the angle. The lesions were of soft consitency with relatively smooth surface. There was no erosion or reddening. Histologically the upper half of the protruded mucosa was covered with glands with superficial intestinal metaplasia showing various degrees of atypia. A very minute changes suggesting cancer was found in a part of it. These finding suggested that we were dealing with an incipient stage of canceration. Reference is also made to the literature.


Copyright © 1979, 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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