Small Mucosal Cancer in the Fundic Gland Area, Report of a Case K. Inui 1 1Department of Internal Medicine, Yachiyo Hospital pp.197-202
Published Date 1983/2/25
DOI https://doi.org/10.11477/mf.1403109283
  • Abstract
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 A 27-year-old man visited our hospital with complaint of hunger epigastralgia. X-ray examination showed clearly the shallow depressed area with converging folds on the anterior wall of the lower gastric body, in prone double contrast film and upright compression film. The mucosal convergence revealed abrupt interruption and the tips of the mucosal folds were clubbed and seemed to be fused. The granular mucosa was seen in the depressed area and the small ulcer in it. The initial endoscopy revealed the small ulcer was covered with a white coat. The second endoscopy showed the small ulcer had changed into a scar. The lesion was diagnosed as advanced cancer like Ⅱc+Ⅲs type. The biopsy specimens confirmed signet-ring cell carcinoma. In the resected specimen, the lesion,7×14 mm in diameter, was located in the fundic gland area. Histologically, poorly differentiated adenocarcinoma and signet-ring cell carcinoma were found in the submucosal layer.

 This case seemed to be at one phase of the so-called malignant cycle. The cancerous invasion was found in the mucosal layer within the limits of the edge of the depressed area covered with regenerative epithelium. By x-ray examination, the granular lesion in the Ⅱc area was visualized as a deep cancerous invasion, but retrospectively, the size of the granules seemed to be almost equal. The cancer in the fundic gland area has a tendency of making severe fibrosis in the submucosal layer. The fibrosis of this case was not so severe but it maked us miss the diagnosis. This case made evident the difficulty of the diagnosis of the extent of cancer in the fundic gland area.

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