A Case of Early Reticulum Cell Sarcoma N. Sugiyama 1 , K. Kumakura 1 , M. Maruyama 1 , K. Takagi 2 , K. Nakamura 3 1Dept. of Int. Med., Cancer Institute Hospital 2Dept. of Surgery, Cancer Institute Hospital 3Dept. of Pathology, Cancer Institute Hospital pp.187-193
Published Date 1973/2/25
DOI https://doi.org/10.11477/mf.1403108360
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 A forty-one-year-old male patient came to the Cancer Institute Hospital with a chief complaint of epigastralgia. X-ray examination of the stomach was performed. Barium-filled film revealed narrowing of the gastric antrum. The mucosa of the narrowed portion seemed mostly normal on the double contrast images, but the proximal end of the narrowing, especially that around the greater curvature side, was irregularly granulated. A compression image revealed two niches at the distal portion of the narrowing, and another compression image revealed a faint collection of barium at the proximal, greater curvature side of the narrowing. The faint barium shadow looked as irregular as that observed in a case of early gastric cancer.

 Endoscopically, a shallow depression of the mucosa with a slightly elevated margin was seen at the greater curvature aspect of the antrum. It was not well circumscribed from the surrounding normal mucosa and its surface was granulated. There were seen other two small ulcers at the distal portion of the narrowed antrum.

 In the biopsy studies performed two times, a diagnosis of adenocarcinoma scirrhosum was made. On the resected specimen, there was an irregular depression of the mucosa with a slightly elevated margin measuring 35×30 mm at the greater curvature aspect of the antrum, and yellowish discoloration including the lesions was observed in the greater part of the antum. There were also two symmetrical ulcer scars (kissing ulcer) near the pyloric ring.

 Histological examination of the irregular depression disclosed reticulum cell sarcoma (RCS) which was limited to the submucosa. It may be called “early reticulum cell sarcoma”, if the definition of early gastric cancer be adopted. The discoored portion corresponded to an extensive fibrosis of the submucosa of the antrum. Two symmetrical ulcer scars were proved to be benign (Ul-ⅡS).

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