A Histopathological Study on the Typical Type IIb Early Gastric Carcinoma Keijiro Araki 1 , Susumu Yamasaki 1 , Masamitsu Kumon 1 , Yoshihiko Nakazawa 2 , Yasutake Yamamoto 2 1The First Department of Surgery, Kochi Medical School 2The First Department of Internal Medicine, Kochi Medical School pp.389-394
Published Date 1986/4/25
DOI https://doi.org/10.11477/mf.1403110227
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 Twenty-three cases of the type IIb gastric carcinoma were reviewed regarding some issues on the definition, the significance and the factors to form IIb lesion. Although the type IIb is defined as the type of carcinoma that has macroscopically the same height as the surrounding mucosa, the difference of less than 0.1mm should be allowed because of the inability to discriminate such a level of difference macroscopically.

 The sizes of lesions varied from 1mm to 75 mm in diameter. Acidity of gastric juice was low especially in the cases with larger Iesion. The smaller lesions most of which were detected in the resected stomach coexisted with other types of carcinoma. The larger lesions detected clinically were located in the middle or upper part of the stomach. It was speculated that the larger Iesion resulted from the intramucosal spread (horizontally) of carcinoma under the circumstance of hypoacidity, and that the smaller lesion signified the incipient phase of carcinoma.

 Differentiated adenocarcinoma was seen with high frequency (82.8%). On histological and dissecting microscopical examination of typical IIb, differences between differentiated and undifferentiated carcinoma were found in the histological construction and the structure of the surface. In the differentiated carcinoma, atypisln was extremely low when it occupied the whole thickness of mucosa, while in case of higher atypism did not occupy the whole mucosa. When exposed to the surface, carcinoma showed various patterns of structure described as finger-like, network or flat. Before the exposure, the carcinoma with the epithelium on it and the gastric glands in it with undifferentiated type appeared slightly edematous and irregular compared with the normal mucosa around it.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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