隆起を主体とした表層拡大型胃癌の1例

Elevated Superficial Spreading Type of Gastric Cancer, Report of a Case

　われわれは胃角部にⅡa集簇型があり，その口側に不整な陥凹を含む低いⅡa部分があり，これらの周辺にⅡb様病変が広範囲にみられた隆起を主体とする表層拡大型胃癌の1例を経験したので，この症例のⅡb様病変部のX線所見について若干の検討を加えて報告する.

　A 38-year-old woman without any complaints was referred to our hospital for check-up because of abnormality pointed out previously at the gastric mass survey.

　The radiographic examination revealed multiple polypoid lesion in the angular region as well as irregular areae gastricae pattern uneven in size and shape with irregular-shaped depression in the oral side of the polypoid lesions.

　In addition, an irregular mucosal pattern presenting a faint barium coating area with minute barium flecks was recognized on the adjacent posterior wall in the oral side of the lesion.

　Endoscopy revealed the coarse and fragile mucosa over the polypoid lesions and the adjacent area.

　Gross observation of the resected specimen showed a nest of multiple Ⅱa-like protruded lesions on the gastric angle, flat elevated area (Ⅱa) with irregular depression (Ⅱc) in the oral side of the lesions, and whitish-discolored, flat area (Ⅱb) extended around the lesions. These findings were indicative of a type of superficial spreading carcinoma of the stomach.

　Histologically, cancer was found to be limited to the layer of mucosa and submucosa in most of the lesions, part of which invaded into the subserosal layer in the depressed area of mucosa. The whole lesion measured 13 cm by 10 cm.

　It can be emphasized that the findings of Ⅱb-like lesion in the present case demonstrated well in both x-ray and histological examinations are of great importance in the future diagnostic process of Ⅱb-like lesion by x-ray.