胃体部大彎側Ⅱc＋Ⅲ型早期癌の1例

A Case of Ⅱc＋Ⅲ Type Early Gastric Cancer on the Greater Curvature Side of the Body

　胃X線診断学の目ざましい進歩によって，胃のどの部位の早期癌も殆んど診断できるようになった．今なお，診断の比較的むずかしいといわれている部位の早期胃癌は，前壁側のある部位，体部大彎側及び高位に発生したものであろう．著者らは，胃X線検査で前庭幽門部に多発性ポリープを有し，体部大彎側やや前壁寄りに比較的広範なⅡc＋Ⅲ型早期癌を疑い，胃X線精密検査，胃カメラ検査及び胃生検にて，確定診断し得た症例を経験したので，X線検査法を中心に報告する．

　A report is made of a case of early gastric cancer located in the greater curvature side of the body, which is, along with certain parts of the anterior wall and the upper portions of the stomach, is still considered least amenable to the diagnosis of early gastric cancer. Special emphasis is laid on the x-ray examination method in this case. X-ray revealed a relatively extensive lesion suspicious of Ⅱc＋Ⅲ subtype early cancer in the greater curvature side of the body near the anterior wall, in addition to multiple polyps in the antrum. The lesion in the body was confirmed as cancer by thorough examinations.

　The merits of this examination method are: 1) Changes of the contour are well visualized by alternating degrees of barium filling: 2) lesion extending over to the anterior wall is delineated as well by prone double contrast method over-distending the stomach, with the amount of contrast meal and insufflated air adjusted as the occasion demands: and 3) lesion spreading onto the posterior wall is pictured well by supine first oblique position, or by almost side view.