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IIa-Subtype: Its Morphology, Clinical Course and Clinicopathological Specificity S. Fukuchi 1 , T. Mochizuki 2 1Department of Gastroenterology, Toranomon Hospital 2Department of Pathology, Tokyo Senbai Hospisal pp.407-413
Published Date 1982/4/25
DOI https://doi.org/10.11477/mf.1403108845
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 Clinicopathological background of IIa-subtype is quite characteristic because it is almost always seen in aged patients who have severe atrophic gastric mucosa associated with intestinal metaplasia. Their gastric secretory function is markedly reduced and there is also increased incidence of coexisting well-differentiated adenocarcinoma in the same stomach.

 These characteristics are quite different from hyperplastic polyps and forming a pronounced contrast with them. Clinicopathological background of polypoid cancer is mimic to the IIa-subtype but a degree of mucosal devastation and decreased secretory function are more prominent rather in the IIa-subtype. Fundamental macroscopic feature of the IIa-subtype is flat protruded lesion with broad base similar to IIa. Studying the clinical course, its growth presumed to be very slow and it may become hemispherical but rarely has stalk. Although follow-up of clinical course of the IIa-subtype has been still less than 10 years, most cases showed no significant changes and repeated biopsies caused its decrease in size or disappearance in some cases.

 These facts suggest that the IIa-subtype has less proliferative character. Excluding misdiagnosed cases, no essential change in the histology of the biopsy specimen has been noted and so far no cases have been reported to have a sign of malignancy or differentiation into metaplastic intestinal epithelium.

 The above findings suggest that the lesion of IIa-subtype, which is our tentative name, is a distinctive clinical entity and it is considered to be one of the representative case of protruded epithelial lesions along with benign hyperplastic polyp and malignant polypoid lesion. However, it has not been well defined whether the lesion is considered to be neoplastic proliferation or adenoma.


Copyright © 1982, 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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