Ⅲ＋Ⅱcに酷似せる良性潰瘍の1例

ONE CASE OF BENIGN ULCER RESEMBLED TO Ⅲ+Ⅱc

Ⅰ．緒言

　著者らは胃X線及び胃カメラ検査で早期胃癌と診断し，切除胃の肉眼標本でも早期胃癌と考えたが，病理組織学的には良性潰瘍であった非常に興味ある1症例を経験したので，ここに報告する．なお本症例は昭和42年12月東京の早期胃癌研究会において発表した．

　One case which had been diagnosed Ⅲ+Ⅱc type early gastric cancer by X-ray and gastrocamera examination, and by macroscopic findings of operated specimen, but cancer was denied by histopathological examination, was reported. Patient was 49 years old female and her chief complaint was heart burn. Father had died with gastric cancer at the age of 68 years. Epigastric pain with no relation with meals had appeared since November ‘66’ Diagnosis of gastric ulcer was made and symptoms were disappeared by drug therapy. In March ‘67’ same pain had appeared and diagnosis of gastric ulcer was made by same doctor again. Therapies had been continued by this doctor but heart burn became severer in October that this patient visited our clinic. Irregularity of gastric relief was noticed by compressed method of X-ray examination. Rod like elevation of gastric fold at the posterior wall of corpus was recognized by gastrocamera examination. Irregularity of relief and shallow excavation were noticed at anterior wall of corpus. Macroscopic and histopathological findings of stomach were as follows; Ulcer 4mm in diameter was seen at posterior wall of corpus and gastric folds disappeared gently at the place a little bit apart from ulcer. Flat elevation was noticed at anterior wall of corpus. Changes at the posterior wall of corpus were benign ulcer by pathological examination and hypertrophy of submucosal layer was noticed. Change at anterior wall was only hypertrophy of submucosal layer.

　In this case, the hypertrophy of submucosal layer modified the changes complicatedly. This was the reason why the benign change seemed to be malignant one. Attention must be given, because changes at greater curvature, anterior wall and posterior wall are often accompanied with hypertrophy of submucosal layer.