Radiological Diagnosis of Type Ⅱb and Ⅱb-like Lesions of the Stomach K. Kumakura 1 , M. Maruyama 1 , N. Sugiyama 1 1Dept. of Internal Medicine, Cancer Institute Hospital pp.21-36
Published Date 1972/1/25
DOI https://doi.org/10.11477/mf.1403108967
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 During the six years 1965 through 1970, 337 cases of early gastric cancer had been operated on in the Cancer Institute Hospital. Of these, the number of the most suitable cases for analysis in the radiological diagnosis of Ⅱb was 17 (18 lesions): one typical Ⅱb lesion, another Ⅱb-like lesion and 16 Ⅱb-like lesions concomitantly found in the course of surgical correction for other types of early cancer. In addition, two more lesions were included which slightly invaded the proper muscle layer (pm). (1) According to the conventional classification these 20 lesions were divided into Ⅱb, Ⅱb+Ⅱa, Ⅱb+Ⅱc and Ⅱb+Ⅲ. Only three lesions were free of ulceration, and the rest had either ulcer or ulcer scar ranging from Ul-Ⅱ to Ul-Ⅳ. (2) One typical Ⅱb and one Ⅱb-like lesion were smaller than 20 mm in diameter and were unassociated with ulceration. Fourteen of 20 lesions were larger than 50 mm, and four of them were over 100 mm in diameter. (3) Their macroscopic characteristics were divided into three varieties: (a) lesion with no difference from the surrounding mucosa; (b) lesion with its mucosal surface more smooth than the normal one; (c) lesion with its mucosal surface more nodular than the encircling normal mucosa. Of these, (c) was most correctly demostrated in a double contrast image. However, at times both (a) and (b) were also visualized in the double contrast picture as a faint barium fleck or difference in barium coating.

 In the same period, 69 lesions of microcarcinoma (7 of Ⅱa, 26 of Ⅱb and 36 of Ⅱc) had been discovered by Nakamura after close histological examination, the results of which seem to show that typical Ⅱb in the strict sense of its definition is to be found in those microcarcinomas less than 5 mm in diameter. Retrospective study of radiological findings in these microcarcinomas has also shown that there were several cases radiologically visualized. Of these, three cases are demonstrated in this paper.

Copyright © 1972, Igaku-Shoin Ltd. All rights reserved.


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