21ヵ月にわたり逆追跡資料の得られたlinitis plastica型胃癌の1例

Natural History of Linitis Plastica Type of Gastric Carcinoma, Report of a Case

　胃壁のびまん性癌浸潤により，胃内腔の狭小化を来したlinitis plastica型胃癌の予後は悪いが，多くの努力によりその早期像がしだいに明らかになりつつある．

　渡辺ら¹⁾はlinitis plastica型胃癌の初期像は未分化型癌のうちで消化性潰瘍のないⅡc型であることが最も多く，潰瘍があっても粘膜下層以下の深層の癌巣に対して相対的に小さい潰瘍を伴う場合であると述べ，また，美園ら²⁾は胃底腺粘膜より発生した未分化癌で，粘膜ひだ集中のない2.0cm以下の小さなⅡc型癌であるとみなされると報告し，臨床医に具体的な早期像を呈示した．著者らは逆追跡資料を21カ月間にわたり得られたlinitis plastica型胃癌の1例を経験したので，そのX線像および内視鏡像からその早期像と今後の早期発見について検討した．

　A 62 year-old man with linitis plastica type gastric carcinoma was retrospectively studied endoscopically and radiologically. He had been examined his stomach during 18 months before developing to “leather bottle stomach” and the stomach was totally resected.

　Macroscopic and histologic findings of the resected stomach showed that the primary lesion had been located on the lesser curvature of the gastric angle. And retrospectively, we could observe some features of early stages of this linitis plastica type gastric cancer, such as Ⅱc type of small sized early gastric cancer, at 18, 17, 14 and 8 months before developing to “leather bottle stomach”, retrospectively.

　From this case, it coud be concluded that every 10 months follow‐up study might be necessary for the early detection of linitis plastica type gastric cancer.