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The Limitation of the Radiologic Method in Estimating the Extent of Carcinomatous Invasion into the Deep Layers of the Gastric Wall A. Nakai 1 , H. Taniguchi 2 , T. Iwanaga 3 , T. Sakai 1 , H. Matsuda 1 1The Department of Radiology, The Center for Adult Diseases 2The Department of Pathology, The Center for Adult Diseases 3The Department of Surgery, The Center for Adult Diseases pp.739-751
Published Date 1972/6/25
DOI https://doi.org/10.11477/mf.1403109142
  • Abstract
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 The limitations of the radiologic method in estimating the extent of carcinomatous invasion into the deep layers of the gastric wall were evaluated on the basis of comparing the macroscopic-radiologic features with the histologic findings of the specimens in 236 cases of early gastric carcinoma and 436 of advanced one in our own material.

 In gastric carcinoma of protruded type (early carcinoma of Type Ⅰ, advanced carcinoma of Borrmann Type Ⅰ, early carcinoma of Type Ⅱa and advanced carcinoma with macroscopic features resembling Type Ⅱa) the size of a tumor is essential to estimating the extent of carcinomatous invasion into the gastric wall. In the second place, the presence of a peduncle at the base of the tumor in early gastric carcinoma of Type Ⅰ and a combined depression on the very flat elevation of the mucous membrane in early gastric carcinoma of Type Ⅱa ought to be taken into consideration for the estimation of carcinomatous invasion into the gastric wall. In conclusion one is able to estimate radiologically the depth of carcinomatous invasion into the gastric wall with sufficient accuracy, since there is every possiblity of delineating these macroscopic features mentioned above by radiological method.

 As to gastric carcinoma with heaped up margin and depressed center (early carcinoma of Type Ⅰ with superficial defect, early carcinoma of Type Ⅱc without converging folds and advanced carcinoma of Borrmann Type Ⅱ), carcinomatous infiltration into the gastric wall is not uncommon, even if the tumor is very small. Hence the characteristics for estimating the extent of the deeper invasion were searched for as to both macroscopic-radiologic appearances of the contour and surface of the trancelucency due to the marginal elevation and those of the contour of the central depression. A certain correlation was found between those macroscopic-radiologic appearances and the extent of the invasion of gastric carcinoma in this category. The radiographic features, however, are not always faithful to the macroscopic appearances of these lesions according to the localization of gastric carcinoma or the method of the radiologic examination employed, so that the reliability on the supposed extent of carcinomatous invasion into the gastric wall on the basis of the gross radiologic appearance should be investigated hereafter.

 Concerning gastric carcinoma of depressed type, only advanced carcinoma with the macroscopic appearances resembling any one of early gastric carcinoma of Type Ⅱc with converging folds, Type Ⅱc+Ⅲ and Type Ⅲ+Ⅱc was discussed, because advanced carcinomas of this type were mostly of advanced carcino-ma in our material. The advanced carcinoma of depressed type was divided from the histopathological features of carcimatous invasion in the gastric wall into the following 3 types: 1) minimal infiltrating type, 2) diffuse infiltrating type and 3) localized infiltrating type. In the minimal infiltrating type it was almost impossible to differentiate advanced gastric carcinoma from early one, while this differentiation was not difficult in diffuse infiltrating type. The localized infiltrating type was somewhat in-between in the possibilities of estimating the extent of carcinomatous invasion into the deeper layers of the gastric wall.


Copyright © 1972, 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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