多発胃癌に合併したⅡb型早期胃癌の1例

Gastric Cancer Type IIb in the Multiple Gastric Cancers, Report of a Case

はじめに

　近年，胃X線診断および内視鏡診断の進歩に伴い，より小さな，より高低差の少ない早期胃癌が発見されるようになってきている．しかしながら，現在に至っても5mm以下の微小胃癌や高低差のないⅡb型胃癌の診断は極めて難しいと言わざるを得ない．今回，多発胃癌に合併した高低差のほとんどない，いわゆる純粋Ⅱbとみなしうる症例を呈示する．

　The patient, 27-year-old woman, complained of hunger pain in the epigastrium. Three gastric cancers（①Borrmann type 3 cancer on the anterior wall of the antrum, ②type IIc-mimicking advanced canceron the posterior wall of the lower body, ③type IIc cancer on the anterior wall of the angle) were discovered by the x-ray and the endoscopic examinations. On the pathological examination, however, as many as 19 cancers were identified. In this report, we exhibited x-ray, endoscopic and pathological findings of one of these 19 cancers, the type IIb gastric cancer (signetring cell carcinoma measuring 13×9mm, m). The morphological difference between the IIb lesion and the normal mucosa around it could not be determined on the retrospective examinations of either x-ray, endoscopy or macroscopy.