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Intramucosal Carcinoma of the Stomach Diagnosed Preopepatively as Type Ⅱc Infiltrating the Submucosa, Report of a Case S. Sai 1 , M. Kikuchi 2 1Department of Gastroenterology, The University of Tsukuba School of Medicine 2Department of Pathology, The University of Tsukuba School of Medicine pp.555-559
Published Date 1982/5/25
DOI https://doi.org/10.11477/mf.1403108933
  • Abstract
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 A 39-year-old housewife was admitted to our hospital with chief complaint of sensation of abdominal fullness after meals. The double contrast picture of the stomach showed a shallow depressive lesion accompanying with convergence and interruption of rugal folds on the anterior wall of the antrum near the greater curvature. Irregularity and rigidity were also noted on the corresponding area (Fig. 1, 2). The endoscopic picture revealed an irregularly shaped ulcer on the anterior wall of the antrum with a rough ulcer base and a raised platform-like margin. Based on these findings, a Type Ⅱc infiltrating the submucosa was considered.

 Biopsy materials revealed undifferentiated carcinoma showing trabecular pattern (Fig. 5). In the resected stomach, the lesion showed a typical Type Ⅱc of undifferentiated carcinoma, measuring about 4×3 cm in dimensions and located in the anterior wall of the antrum near the greater curvature (Fig. 6, 7). The Ⅱc lesion was diagnosed histologically as undifferentiated carcinoma showing trabecular arrangement and signet-ring cell pattern, and limited to the mucosa (Fig. 9). The Ⅱc lesion was accompanied with an ulcer of Ul-Ⅱ, in which extensive fibrosis of the submucosa was noted (Fig. 8).

 Rigidity of early cancerous lesion has been generally mentioned as a radiological sign of submucosal invasion of cancer cells. Although a double contrast picture showed radiologically and endoscopically rigidity in this case, cancer was histologically limited to the mucosa. Radiological rigidity of the gastric wall was attributable to extensive fibrosis of the submucosa. Consequently, radiological rigidity is not always correspond to submucosal invasion of cancer cells when there is ulcerative lesion in early gastric cancer.


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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