Ⅱc型早期胃癌とY字形の潰瘍瘢痕とが共存していた例

A CASE OF Ⅱc TYPE EARLY GASTRIC CANCER COEXISTENT WITH AN ULCER SCAR FORMED LIKE THE LETTER Y

Ⅰ．症例

　患者：T・M　65才　男

　主訴：心窩部痛

　初診：42年6月20日

　手術：42年8月4日

　切除胃所見：

　　1）深達度mのⅡc型早期胃癌（幽門前庭部）．

　　2）Y字形の潰瘍瘢痕（胃角部）．

　Case: T.M., 65 years old male. Chief complaint: epigastralgia.

　Findings of the resected stomach:

　1. Ⅱc type early gastric cancer (pyloric antrum)

　2. a Y-letter-formed ulcer scar (gastric angle)

　The first lesion, measuring 28 by 14 mm, was a Ⅱc type early gastric cancer having “m” degree of depth invasion.

　The second lesion,4cm long, bifurcated like the letter Y, showed Ul-Ⅳ ulcer scar in its central portion, while Ul-Ⅲ scars were observed in its both ends. At one end of the ulcer scar toward the posterior wall had been observed a round niche the size of a forefinger-tip at an x-ray examination done 45 days prior to the operation. The course of this ulcer had been weekly followed up by x-ray. A pattern as of a plum blossom, recognized at an x-ray examination conducted 35 days after the initial one, was diagnosed as an ulcer scar. This was further confirmed as such histologically after the operation performed ten days later. The thickness of the mucosal layer over the Ul-Ⅲ ulcer scar was almost the same as that of the mucosal layer in the surrounding area.