著明な表層拡大を示したⅡc型sm胃癌の1例

Superficial Widespreading Gastric Cancer, Type Ⅱc, Infiltrating the Submucosa, Report of a Case

　われわれは著明な表層拡大を示した深達度smⅡc型胃癌を経験したので報告する．

症例

　患　者：78歳，女．

　主　訴：めまい．

　既往歴，家族歴：特記すべきものなし．

　現病歴：1976年より貧血を指摘され，某大学病院にて消化管をはじめとする精密検査を受けたが異常は指摘されなかった．その後自覚症状なく放置していた．1979年3月悪心，嘔吐．食欲不振が出現し，投薬にて1～2週間で軽快した．同年4月ごろめまいが出現し，近医で鉄欠乏性貧血の診断を受け精査を目的に当内科に紹介され，1979年5月15日入院した．

　The patient, a 78-year-old woman, had suffered from dizziness for three years and was diagnosed as having anemia by a doctor.

　At our hospital, x-ray and endoscopic examinations revealed a superficial widespreading gastric cancer (Type Ⅱc) measuring about 9×5 cm in dimensions and located in the middle portion of the stomach along the lesser curvature (Fig. 1～4). The Ⅱc lesion was diagnosed radiologically and endoscopically as differentiated carcinoma infiltrating the submucosa, because there was rigidity of the lesser curvature of the angular region.

　Biopsy material revealed adenocarcinoma tubulare (Fig. 5).

　In the resected stomach, there was a superficial widespreading Ⅱc lesion, measuring about 11×10 cm, located in the middle portion through the lesser curvature (Fig. 6, 7).

　The Ⅱc lesion was diagnosed histologically as well-differentiated tubular adenocarcinoma infiltrating the submucosa (Fig. 8, 9).

　The case shows macroscopically and radiologically a typical Type Ⅱc of differentiated carcinoma.