胃体下部大彎側の早期胃癌の1例

A CASE OF EARLY GASTRIC CANCER ON THE GREATER CURVATURE

Ⅰ．緒言

　大彎側の前庭部に発生した早期胃癌にはしばしば遭遇するけれども，前庭部より口側の大彎側に発生した早期胃癌は比較的稀である．著者らは胃体下部大彎側の早期胃癌の1例を経験したのでここに報告する．

　Patient: housewife, 48 years of age.

　Chief complaint: epigastralgia.

　Family history: the father of the patient died of liver cancer at the age of 60.

　Early history: tuberculosis at the age of twelve.

　History of the present illness: Since April of this year the patient began to feel dull pain below the heart, and it was not associated with food taking.

　X-ray examination: Barium-filled picture, standing position, face-on view, revealed irregular rigidity and poor distensibility of the greater curvature of the lower gastric corpus.

　Mucosal picture and double contrast study brought out the convergence of relief, with its clubshaped hypertrophy and star-shaped flecks.

　Endoscopic examination: On the greater curvature of the lower gastric corpus, and toward the posterior wall was seen the protuberance of the gastric rugae. Several small protuberances were found toward the pylorus and the greater curvature. The color of the mucosa remained unchanged.

　Observation of the resected stomach: Macroscopically convergence of gastric rugae as well as club-shaped (protuberance 'was observed on the greater curvature of the gastric corpus. By pathological and histological examination, this was proved to be a small ulcer (Ul-Ⅱ), 0.6 cm in diameter, and cancer cells were detected at the margin of the ulcer. It was carcinoma solidum simplex, in part reaching to the submucosa. At the margin of the ulcer there existed proliferation of the submucosal layer. This case resembles the one reported by Muramatsu, and it was assumed that when ulcerous lesion exists on the greater curvature of the lower gastric corpus, convergence of gastric rugae and the submucosal proliferation are apt to occur there.