A Ⅱc+Ⅱb Early Gastric Cancer, Report of a Case M. Saito 1 , T. Igarashi 1 , T. Murai 1 , M. Utsumi 1 , T. Gonoi 1 12nd Dept. of Int. Med., Fukushima Medical School pp.1351-1356
Published Date 1972/10/25
DOI https://doi.org/10.11477/mf.1403109074
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 The patient is a 47-year-old woman with a diagnosis of II c subtype early gastric cancer, measuring 22×20 cm, located on the posterior wall from the level of the angle down to the pyloric antrum. Depth of invasion was m. Histologic type : signet ring cell carcinoma, intermixed partially with well-differentiated adenocarcinoma.

 Gross findings of the resected stomach : There were few macroscopic changes. The area of cancer was almost of the same height as the surrounding normal mucosa. In the center of the lesion and in its posterior wall side was the granular change characterized by difference in size of granules with their outline presenting worm-eaten picture. Otherwise the change was unnoticiable.

 X-ray findings : Serial radiographs in double contrast, with the air so proportioned that the mucosal folds were not too flattened out, revealed the lesion as a depressed area along the margin of the lesser curvature. Macroscopically, there had been scarcely any change of height between this area and the other adjoining mucosa. The lesion pictured in x-ray was encircled in its whole circumference by a thin strip of radiolucency. These findings were interpreted as arising out of difference in distensibility between the involved and normal areas. The fact that the lesion was more distinct in x-ray than in gross observation seems to show that x-ray can demonstrate lessened distensibility of the gastric wall or its rigidity otherwise difficult to find out. When serial exposures are taken in double contrast with well proportioned air within the stomach, slight cancerous changes scarcely visible to the naked eye seem to be now within reach of x-ray diagnosis.

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