Ⅱb型早期胃癌の1例

ONE CASE OF Ⅱb TYPE EARLY GASTRIC CANCER.

Ⅰ．はじめに

　早期胃癌に対する認識が深まり，臨床検査が進歩するにつれ，臨床診断の理想像として組織規準で考えられてきたⅡb型早期胃癌（日本内視鏡学会案による早期胃癌分類）が，肉眼的に把握出来る時代になって来た．われわれも臨床診断が可能なことを示唆するⅡb型早期胃癌症例を経験したので報告する．

　Patient was 61 years old male. He had been examined since 1964 periodically. On September ‘66’ elevated change at the greater curvature of pylorus was found. On March ‘67’ he was admitted for surgical treatment. By X-ray and endoscopic examination, this change was diagnosed as the doubt of Ⅱa+Ⅱc type early cancer and Ⅱc+Ⅱa type early cancer. On April ‘67’ gastrectomy and clean-up of lymph nodes were performed. On the specimen, Ⅱa+Ⅱc type elevated change at the greater curvature of pylorus and Ⅱc+Ⅱa type superficial, bounded, mucosal change at greater curvature were observed. Former change was situated 7.2 cm from pylorus ring and 0.7×0.9 cm in size. Later change was situated 2.2cm from pylorus ring and 2.0×5.2 cm in size.

　By histological examination, former one was diagnosed as Ⅱa+Ⅱc like production of atypical epithelium and later one was diagnosed as Ⅱb type early cancer.

　It is very interesting to reveal roentogenologic image of mucosal change of Ⅱb type early gastric cancer by X-ray examination.