深達度診断の困難であったⅡc＋Ⅲ型早期胃癌の1例

Early Gastric Cancer, Type Ⅱc+Ⅲ, Report of a Case

要旨　術前，深達度mと診断されたが，最終病理組織診にて潰瘍瘢痕部に一致して粘膜下組織に癌浸潤を認めた，Ⅱc＋Ⅲ型早期胃癌の1例を提示した．

　A 52-year-old man was admitted to Yamagata University Hospital for further examination of the stomach in April 1983. Radiological study of the stomach revealed an irregular shallow depression with fold convergence on the anterior wall of the upper part of the gastric body. Converging mucosal folds had neither swelling nor fusion of the tips. Almost the same findings were shown by the following endoscopic study. Preoperative diagnosis was Ⅱc+Ⅲ type gastric cancer limited to the mucosa. Total gastre ctomy was carried out one month after admission. Naked-eye inspection of the resected stomath revealed an open ulcer (0.5×0.5 cm in diameter) in the center of the shallow depressed lesion (1.5×1.0 cm in diameter) with convergence of folds.

　Histological examination showed moderately differentiated tubular adenocarcinoma with the cancer slightly infiltrating the mucosal layer through to the submucosal layer in which fibrosis accompanied with ulceration was observed.

　In diagnosis of gastric carcinoma with ulcer and/or ulcer scar we must pay great attention to the extent to which it has invaded the mucosa.