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A Case of Extensive Ⅱc Type Early Gastric Cancer Adjacent to Groups of Ⅱa-like Protrusions Yuzo Akasaka 1 1Kyoto Prefectural University of Medicine, Department of Medicine pp.199-203
Published Date 1970/2/25
DOI https://doi.org/10.11477/mf.1403111200
  • Abstract
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 Case: 70 years old male.

 He had no subjective symptoms except loss of weight (5 kg in 2 years) till Dec. 1968, when he underwent a gastric mass survey. Subsequent thorough examination revealed no particular abnormalities in the upright, barium-filled pictue (Fig.1).

 Mucosal study in the prone position (Fig.2) as well as the double contrast radiograph in the supine position with various amount of air (Fig. 3, 4 and 5) disclosed irregularity of the mucosal folds on the anterior and posterior walls of the angle and the lower body. A shallow depression with interrupted folds was also observed on the irregular mucosa of the posterior wall of the body.

 Endoscopic examination likewise revealed elevation of the mucosa of irregular shape at the gastricangle (Fig.6) together with a depression having interruption of the radiating folds on the posterior wall of the body (Fig.7).

 Of 8 sections of gastric biopsy available for study, malignant cells were demonstrated in 3 (Fig.9).

 Gross specimen showed superficial elevation of the mucosa at the angle (Ⅱa).

 adjacent to an extensive shallow depression on the large rough surface of the mucosa of the body (Ⅱc).

 Histologically there was revealed intramucosal and unfferentiated carcinoma of the stomach with no metastasis in the lymphnodes (Fig. 8, 9, 10).

 In this case, following points are interesting.

 1) The distension of the gastric wall by various amount of air or contrast medium is useful for the diagnosis of superficial type of early gastric cancer.

 2) Gastric biopsy is of use for the differential diagnosis and for determining the extent of cancerous invasion.

 3) Detection of the depression with interrupted radiating folds is of much account for the diagnosis of superficial type of early gastric cancer.


Copyright © 1970, Igaku-Shoin Ltd. All rights reserved.

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

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