早期胃癌を伴ったいわゆる胃ポリポージスの1例

A CASE OF GASTRIC POLYPOSIS ACCOMPANIED WITH EARLY GASTRIC CANCER

Ⅰ．はじめに

　近年胃隆起性病変に対する関心が高まり，多くの研究ならびに症例が報告されている．最近当教室においても，いわゆる胃ポリポージスに早期胃癌を合併した症例を経験したので，病理組織学的検討を加えて，その大要を報告する．

　Case: a 49-year-old female.

　She visited the authors' hospital on account of dull pain in the lower abdomen. Roentgenologically near the gastric angle were found many round shadow defects of various sizes, some of them being the size of a bean and others the size of a little-finger-tip. There was also another shadow defect the size of a nut on the posterior wall in the corpus.

　Endoscopy revealed a mucosal protuberance on the upper posterior wall of the corpus, accompanied with granular unevenness with erosion and bleeding on its surface, the whole picture strongly suggestive of a malignant lesion. Cytologically it was diagnosed as cancer positive as atypical cells of the same nature was confirmed.

　Postoperative histological study disclosed that the gastric mucosa as a whole presented itself as an extensively atrophic hyperplastic gastritis with many polypoid protrusions. Of these, those on the upper posterior wall in the corpus proved to be mucosal cancer, while those on the their basal portions and surrounding mucosa were confirmed as belonging to chronic atrophic hyperplastic gastritis.

　Observation of various phases of histopathological changes as confirmed in this case seems to show that atrophic hyperplastic changes in the gastric mucosa are strongly suggestive of pre-cancerous lesions.