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Superficial Flat Carcinoma, Ⅱb Type Detected by Using Dye Endoscopy, Report of a Case Masayoshi Mai 1 , Isao Takeuchi 2 1Department of Surgery, Cancer Research Institute Hospital, Kanazawa University 2Department of Internal Medicine, Takeuchi Hospital pp.423-426
Published Date 1986/4/25
DOI https://doi.org/10.11477/mf.1403110248
  • Abstract
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 Recently the diagnostic technic for gastric cancer seems to have made tremendous progress in the field of endoscopy. At the same, there has been a trend that our interests have been forcussed on the detection of Ⅱb type with little surface characteristics. In order to detect Ⅱb, we have routinely employed the dye endoscopy using both Indigocarmine (IC contrast method) and Methylene blue (MB staining method). In this paper a representative case of Ⅱb was reported.

 The patient was a 66 year-old male who had been treated as an out-patient for diabetes mellitus. Two month sprior to this admission he had workup of GI tract done because of abdominal discomfort off and on. Upper GI series disclosed slight irregularities along the lesser curvature of the mid-body of the stomach. Although an ordinary endoscopy showed no particular abnormalities, IC contrast picture showed an irregular and coarse granular mucosa with scattered redness. Such granular appearance inside the lesion was clearly dipicted as cancerous, and in fact, the biopsy showed signet-ring cell carcinoma. Grossly, however, the Ⅱb lesion could not be identified in partially resected specimen and the proximal boundary of cancer infiltration was not determined. Based upon the positive result for cancer cells microscopically at the frozen sectlon of proximal mucosa of surgical incision line, total gastrectomy was successfully carried out.

 The extent of cancer infiltration was confirmed by histologically investigating serial sections of resected stomach, i.e., 3.5×1.9cm in size. Therefore, it is no doubt that the dye endoscopy will contribute considerably to improving the diagnostic ability to detect superficial flat carcinoma (Ⅱb) by identifying these hitherto undetectable minute changes through the enhancement by IC and MB dyes of the topographic variations in the mucosa.


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

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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