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A CASE OF Ⅱc+Ⅲ TYPE EARLY GASTRIC CANCER SHOWING SANCTUARY PATTERYN Hideo Hiratsuka 1 1Hiratsuka Surgical and Gastroenterological Hospital pp.775-780
Published Date 1969/6/25
DOI https://doi.org/10.11477/mf.1403111128
  • Abstract
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 A 59-year-old female, in whose stomach an abnormal finding had been detected by a local gastric mass survey, was determined as harboring early gastric cancer by a subsequent thorough examination.

 X-ray diagnosis of the stomach: Marked convergence of several mucosal folds was seen in an area ranging from the lesser curvature at the gastric angle away to the posterior wall. Some of these rugae were observed to taper away towards the center, while some others became club-like in their tips. A depressed lesion of irregular shape as well as a nodular protrusion, seen to best advantage in double contrast study, was noted in the center of this area. There were clear double contours in the surrounding region. A shadow suggestive of an ulcer lesion was also noted in the lesser curvature side of these lesions.

 Endoscopic diagnosis. An erosion having oval-shaped extent, a little less elevated than the surrounding mucosa, was located at the incisura a little toward the posterior wall. In the center of this depression, a small, shallow ulcer covered over with thick, white exudate was seen. Its closer scrutiny revealed several reddened islet-like protrusions in the depressed region. The mucosal folds, club-like in their tips, abruptly ceased at the edge of the depression. Biopsy was tried on five different spots in this area: they were all positive for cancer.

 Pathological diagnosis: A depressed lesion measuring 30 by 10mm was found in the gastric angle a little toward the posterior wall with a very small Ul-III in its center. The latter was encircled all around by ulcer scars having an extent of 18 by 7mm, all covered by regenerated epithelia. These ulcer scars were further surrounded by IIc type depressions with overlying mucosal cancer cells. In short, the cancer lesions had a ring-like extentiona typical holy place type IIc+III early gastric cancer.

 An inquiry has been made in this paper about this interesting case as it was further associated with duodenal ulcer.


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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