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肉眼的に,Ⅲ+Ⅱc様の陥凹と,その周辺に粘膜下腫瘍様の肉眼形態を示し,組織学的に著明なリンパ球浸潤を伴う進行胃癌の1例を経験したので報告する.
A 45-year-old man with chief complaints of nausea and epigastralgia after meal was diagnosed to have an early stomach cancer type Ⅲ+Ⅱc in the lesser curvature, prepyloric area in UGI x-ray. The shadow consisted of an irregular depression of the mucous membrane and a shadow defect around it.
In endoscopic examination, a submucosal tumor with a depression of mucous membrane, type Ⅲ+Ⅱc on the surface of it, was found. The diagnosis of cancer was made easily from examination of biopsy tissue.
The depth of invasion of cancer cells, however, was not clarified by these UGI x-ray and endoscopic examinations.
In the pathological examination of the tissue after hemigastrectomy, the tumor which contained Ⅲ+Ⅱc depression of the mucous membrane showed cancer cell invasion through the whole layer from the submucosal layer to serosal layer and a remarkable lymphoid cell infiltration in the stroma.
Distant metastases including hepatic and peritoneal ones were not seen at all. Three lymph nodes among 10 N1, however, showed the infiltration of cancer cells.
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