当初キサントーム様所見を呈したⅠ型早期胃癌

A CASE OF EARLY GASTRIC CANCER INITIALLY SIMULATING XANTHOMA

Ⅰ．症例

　患者：66歳　男子　会社員

　家族歴：父は56歳胃癌，父方の祖母は52歳胃癌，父の弟は70歳肝臓癌で死亡．母は91歳で未だ健在である．同胞は6人で，うち長妹は62歳胃癌で死亡．他は健在．

　既往歴：昭和13年マラリアに罹患したほか，特記すべき事項はない．嗜好品としては，酒5酌程度を毎日，および，約6年前までは煙草20本を喫煙していた．

　Case: a company employee, 66 years old.

　A protruded lesion on the anterior wall at the gastric angle was diagnosed as xanthoma at gastrocamera examination of the stomach and then it was left as it was. Four years and 3 months later the paitent visited the authors' department, when on minute examination of the stomach the previous protrusion was found to have enlarged evidently. By the initial biopsy it was diagnosed as benign atypical epithelium, but it was confirmed by the second one as atypical epitheleium located on the border between benign and malignant areas, so that operation was performed.

　Postoperative thorough examination of the resected specimen revealed a well differentiated type Ⅰ early gastric cancer, in addition to a very small type Ⅱb early cancer on another site.

　This case is of interest not only when the biopsical diagnosis, i. e., atypical epithelium on the border between benign and malignant areas, is compared with its postoperative one, but also because, after following up of 4years' duration of atypical epithelium, now being at issue due to development and popularization of biopsical procedures, a protruding lesion was found to have enlarged and its evolving process was observed.