Histopathological Study on Ⅱb Lesions of the Gastric Carcinoma with Reference to the Mechanism of Their Development H. Ikezono 1,2 , M. Nishizawa 2 , K. Nakamura 1 1Department of Pathology, Tsukuba University, School of Medicine 2Tokyo Metropolitan Cancer Detection Center pp.663-671
Published Date 1983/6/25
DOI https://doi.org/10.11477/mf.1403109468
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 Type of Ⅱb of the early carcinoma of the stomach has been defined as carcinoma almost non-recognizing elevation or depression from the surrounding mucosa at the level, and it is very difficult to diagnose it preoperatively. Although a considerable number of these reports have appeared in recent years, little is known about the mechanism of development of Ⅱb lesions including type Ⅱb per se and partial Ⅱb lesion accompanied with other types of carcinoma. The purpose of this paper is to study histologically the Ⅱb lesions of the gastric carcinoma with reference to the mechanism of their development.

 Subjects for this study consisted of nine cases of type Ⅱb per se, and 30 cases of carcinoma partially accompanying with Ⅱb lesions. As the controls, 31 cases of type Ⅱc (depressed type) were used. These resected stomachs were histologically examined by serially cutting method as shown in Figs. 1b, 2b, and 3b. Gastric mucosa neighboring the Ⅱb lesions was divided according to severity of intestinal metaplasia and mucosal atrophy into three grades, as shown in Table 2.

 In general, gastric mucosae harboring the Ⅱb lesions showed atrophy, especially markedly in the antrum and corpus through the lesser curvature site. There was a tendency that the neighboring mucosae of the Ⅱb lesions showed histologically marked atrophy and intestinal metaplasia, independently of histological types of carcinomas (Tables 4 and 6). These findings in the neighboring mucosae were usually more remarkable than that of the controls.

 In the 30 carcinomas partially accompanying with the Ⅱb lesion, localization of the partial Ⅱb lesion were studied. In 16 carcinomas located in the area through the lesser curvature, the partial Ⅱb lesions were distributed evenly around them. Whereas, in 14 carcinomas located in the anterior and posterior walls, the partial Ⅱb lesions existed at the lesser curvature side of the carcinomas.

 There is the tendency that the carcinoma extending the mucosa is more easily eroded or ulcerated by peptic mechanism than the non-affected mucosa. Therefore, taking the tendency into consideration, those results suggest that carcinoma develops as the Ⅱb lesions when it spreads into markedly atrophic mucosa.

Copyright © 1983, Igaku-Shoin Ltd. All rights reserved.


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