前壁Ⅱcの1例

A Case of Ⅱc Type Early Gastric Cancer on the Anterior Wall

　早期胃癌の診断は，二重造影法や胃内視鏡の普及発達により決してむずかしいものではなくなりつつあるが，前壁早期癌を正確に描出，診断することは容易ではない．とりわけ胃微細病変の質的診断に偉力を示す二重造影法も前壁は極めて弱く熊倉らが新たに前壁二重造影法を考案するまでは報告例が少なかった．本誌上には早川ら，および藤田らの報告があるが，最近熊倉らが前壁Ⅱc症例を集計したところ，昭和43年1月までに22例に達しているという．

　最近，筆者らも典型的所見を呈する前壁Ⅱc型早期癌を経験したので報告したい．

　A 29-year-old anemic female was admitted to hospital with complaint of blood vomiting.

　Double contrast radiograph in the prone position revealed an irregular barium fleck with marked converging folds on the lower part of the corpus. We were also able to see interrupting of the converging folds with slender and irregular ends. Endoscopic observation of its appearance greatly coincided with that of x-ray. Cancer cells were found by the cytologic examination under direct vision with fibergastroscope.

　The surgically resected specimen showed a depressed lesion with irregular edge, 22×18 mm in diameter, on the anterior wall in the lower part of the corpus. Histopathologically this lesion was confirmed as aclenocarcinoma tubulare with mucosal and very slight submucosaol involvement.