胃迷入腺組織から発生し粘膜下腫瘍の形態を示した早期胃癌の1例

A Case of Early Gastric Cancer of Submucosal Form, Derived from the Heterotopic Glandular Tissue

　胃癌は粘膜固有層に原発し胃表面より胃壁深部へ浸潤増殖するものとされている．

　一方，粘膜下組織中に異所性に上皮性成分の存在が認められることもあり，組織学的に膵組織の証明される迷入膵などその代表的なものである．このような異所性の上皮を母地とする癌については過去いくつかの報告がある．最近われわれは，胃粘膜下腫瘍の形態を示し，迷入腺組織より発生したことが明らかな早期胃癌症例を経験したので報告する．

　A case of early gastric cancer has been reported, which at first appeared to be a submucosal tumor and yet proved to be carcinoma histologically. The patient is a 63-year-old male who had also gall stones. The cancer lesion was at the anterior wall of the antrum about 4cm proximal to the pyloric ring. This submucosal tumor had a central pit, and through the very pit the biopsy specimens were taken and diagnosed to be cancer preoperatively. The cancer was limited within the submucosal layer in the form of polypoid type. There was glandular tissue in the submucosal layer beneath around the central pit, and this tissue continued and changed to both of the gastric mucosa and carcinoma. In this heterotopic gland there was no definite pancreatic tissue but a small amount of tissue resembling adenomyoma. Other ductal structures reaching to the cancer resembled the biliary or pancreatic duct. The cancer itself was papillary adenocarcinoma and this we concluded was derived from the heterotopic glandular tissue, most probably belonging to the heterotopic pancreas.