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患 者:○谷美 23歳 ♀
現病歴
昭和45年5月,突然吐血,某病院に入院,輸血600cc受く,昭和45年7月,X線・内視鏡検査施行,異常を指摘されなかった(retrospectiveにはⅡc様病変を認める).昭和45年9月,再び吐血し,輸血1,000ccを受け,昭和46年4月,下血と貧血に気づき,某医でX線検査の結果,胃潰瘍を指摘された.その直後再び吐血,下血あり,Subshock状態で当科に緊急入院.
A 23 years old nurse has experienced thrice recurrent bouts of hematemesis. In April 1971 she was admitted to our hospital with melena, anemia and hematemesis. X-ray pictures revealed an irregular shallow ulceration on the anterior wall of the middle corpus. Endoscopic examinations by GTF-A also disclosed there definite Ⅱc findings such as mucosal convergency towards the lesion and tapering of the folds with islet-like mucosal residues. By biopsy the lesion was diagnosed as adenocarcinoma tubulare mucocellulare, and cytologically it was class Ⅴ.
A few days later subtotal gastrectomy was done. Resected specimen showed an irregular Ⅱc lesion on the anterior wall of the middle corpus. It measured 2.5×3.8 cm. Histopathologically, the carcinomatous infiltration was limited within the mucosal layer and unaccompanied with surface ulcertion. There was no regional lymph node metastasis.
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