Endoscopic Diagnosis of Type Ⅱb Early Gastric Cancer M. Nishizawa 1 , K. Nomoto 1 , J. Kariya 1 , K. Okui 2 , H. Okubo 3 11st Dept. of Int. Med., Faculty of Medicine, University of Chiba 21st Dept. of Surgery, Faculty of Medicine, University of Chiba 3Dept. of Pathology, Funabashi Central Hospital pp.37-45
Published Date 1972/1/25
DOI https://doi.org/10.11477/mf.1403108968
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 If Ⅱb type early cancer is to be defined as that variety of early cancer of the stomach which has, on macroscopic observation of its mucosal surface, no difference in height between it and the surrounding normal mucosa, it can be divided into four groups both according to whether or not it can be distinguished when seen on the surface, and also to whether or not it is flat when observed in the sectioned specimens.

 In that type of Ⅱb lesion that develops singly the size macroscopically to be detected is at least more than 5 mm in diameter. Endoscopically it may be confirmed either as discoloration, reddening, or a small bleeding spot. A Ⅱb less than 5 mm in dimensions is only determined by histological examination. Mostly it is of well differentiated nature.

 When a Ⅱb lesion is concomitantly found with other types of early cancer, it can be as large as 30 mm in diameter, mostly infiltrating the mucosa without showing itself over the mucosal surface.

Such a lesion is seen either as fading of normal mucosal color, or soft, irregular unevenness of the surface (roughness). According as a Ⅱb lesion becomes more exposed over the mucosal surface, it begins to be seen as discoloration, reddening or a bleeding spot. Such a lesion is mostly undifferentiated and has the nature of signet ring cell carcinoma.

 When a Ⅱb is accidentally found with other types of early cancer, it becomes difficult to determine its margins. Consequently, when an endoscopically suspicious area becomes less and less distinct, finally merging into the normal mucosa, it is most important to repeat biopsy at some regular distances toward the cardiac side.

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


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