浅いⅡc型早期胃癌例

A CASE OF SHALLOW Ⅱc TYPE EARLY GASTRIC CANCER

Ⅰ．症例

　患者：31歳女子

　昭和42年6月，心窩部痛があり胃X線検査，内視鏡検査をうけ，胃角小彎に潰瘍瘢痕が認められ，経過観察をするようにいわれていた．その後患者は妊娠したため，約1年後の昭和43年8月再検査をうけ，Ⅱcの疑いで入院した．入院後の精密検査で，胃角小彎を中心としたⅡcであることが確認された．切除胃の病理学的検索では，胃角小彎に約3×3cmの粘膜内癌があり，その周辺は胃粘膜の強い萎縮が認められた．

　An ulcer scar at the gastric angle on the lesser curvature, found in June 1967 by both x-ray and endoscopy in the stomach of a woman 31 years of age, has been followed up since then.

　Although diagnosis of Ⅱc was done prior to the operation by x-ray and endoscopy, its real extent remaind uncertain until the operation. Correlation of x-ray films with gross and pathological findings of the resected specimen revealed that what had preoperatively been considered as a large Ⅱc more than several cm in diameter around the gastric angle was in reality a cancer lesion measuring 3 by 3 cm surrounded by marked atrophic gastritis. The latter had been included in the cancer lesion when its extent had been determined by the preoperative reading of the films. It was diflicult even in macroscopical observation of the resected stomach to confirm the extent of Ⅱc. The cancerous area in the half-fixed specimen looked a little discolored as compared with the surrounding mucosa, but was neither appreciably elevated nor depressed. The cancer lesion was limited within the mucosa and no lymph node metastasis was detected.