Japanese

A CASE OF EXTENSIVE Ⅱb TYPE GASTRIC CANCER WITH GROSS AND HISTOLOGICAL PATTERNS OF MARKED VARIETY Yoshio Konishi 1 1Konishi Surgical Hospital pp.669-675
Published Date 1969/5/25
DOI https://doi.org/10.11477/mf.1403111101
  • Abstract
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 A 56-year-old man visited the authors' hospital because of a niche detected by a mass examination of the stomach. Two small ulcers surrounded by extensive atrophic mucosa were revealed by both x-ray and fibergastroscopic examinations on the anterior and posterior wall of the supraangular region. While under internal treatment, the patient was examined by biopsy as well, since the findings of two ulcerative lesions were such that malignancy could not be ruled out.

 The outcome was that mucocellular carcinoma was detected microscopically.

 The removed stomach showed very varied patterns. Tubular adenocarcinoma of low atypicality (Ⅱb) was found on the mucosa which was remarkably atrophied in a wide area around the gastric angle, followed by two ulcer lesions above-mentioned (Ⅲ). Added to this, besides a shallow depressed area (Ⅱc) surrounding the ulcer on the posterior wall, there were further found two localized, slightly elevated protrusions (Ⅱa) on the lesser curvature as well as an atypically swollen mucosal fold as of a worm (Ⅱa) in one of those converging rugae toward the ulcer scar on the anterior wall. On the mucosal surface of the resected stomach, these multicentric cancers veritably showed variegated patterns.

 Histological findings, no less diversified, further revealed that serial tubular adenocarcinoma was varied in its architecture. Because of the ulcer lesion on the anterior wall cellular atypia was more marked on that side, while on the posterior wall development of mucoid carcinoma was noticed. All these malignant changes developed only in the mucosal layer.

 This case offers some suggestive findings for elucidating variations of Ⅱb type carcinoma as well as the relationship between ulcer and early carcinoma.


Copyright © 1969, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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