The Difference between Ⅱb Lesion and Neighboring Noncancerous Mucosa from the Radiological Standpoint S. Tsukasa 1 1The Second Department of Internal Medicine, School of Medicine, Kagoshima University pp.591-601
Published Date 1983/6/25
DOI https://doi.org/10.11477/mf.1403109457
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 Roentgenographic findings of the resected specimen of type Ⅱb early gastric cancer were classified into three patterns. Several cases detected through x-ray examination on the basis of the classification were demonstrated. The configuration of the area, the mucosal pattern and the distensibility of the wall on double contrast picture of Ⅱb were discussed and some problems remained unsettled were mentioned. Four cases (five lesions) of typical Ⅱb or nearly Ⅱb-like lesions were selected out of cases of three patterns for our research purpose.

 1) Ⅱb lesions detected before operation are as follows: two lesions 20, 10 mm in diameter, two lesions 10, 5 mm in diameter, one lesion less than 5 mm in diameter.

 2) A lesion less than 5 mm in diameter is situated on the lesser curvature and diagnosed by abnormal flexibility and contour. Two lesions are diagnosed by the finding in en faces but the lesions already have a slight factor of Ⅱa or Ⅱc.

 3) The differences of mucosal pattern between the lesion and its neighbors are not recognized in three lesions, but recognized slightly in two other lesions.

 4) Three lesions which show no any change in mucosal pattern on ROG of fixed specimens are diagnosed before operation by means of double contrast method by which the wall is distended.

 5) It is difficult to distinguish the Ⅱb lesions from surrounding normal mucosa and localized small gastritis-mucosa and the ulcer scar near the lesser curvature is often likely to be seen as Ⅱb lesion.

 6) Less false-positive outcome and more exact endoscopic biopsy have come out as matters to be solved hereafter.

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