幽門輪に近接したⅡc型早期胃癌の1例

A Case of Ⅱc Type Early Gastric Cancer Localized in the Pylorus

症例

　患者：52歳　男

　主訴：上腹部膨満感

　既往歴：42歳のとき急性虫垂炎で虫垂切除ならびに右鼠蹊ヘルニヤの手術をうけている．

　家族歴：父が胃癌で死亡している．

　A male 52 years of age visited our clinic with a complaint of epigastric fullness.

　X-ray and endoscopic examinations of the stomach were performed. Barium filled picture of upright frontal view showed stenosis and irregularity of the wall in the pylorus. Double contrast radiograph revealed irregularly granular shadow defects and pale shadow flecks on the posterior wall of the antrum.

　Shallow ulcer was detected in prone compression picture. Reddish appearance and depressed, discolored area were discovered by endoscope on the anterior and posterior walls adjacent to the pylorus ring and diagnosed as Ⅱc type. Gastric resection was performed on June 16, 1969.

　Operative findings indicated depressed changes on the anterior and posterior walls adjacent to the pylorus ring, mainly localized in the lesser curvature side. No metastasis of lymph nodes was detected. Smear preparation taken during operation showed PAP. class Ⅴ. No cancerous infiltration was confirmed on the anal stump by cytological examination. Gross picture of the resected specimen showed shallow erosion measuring 4.5 by 3cms. Histologically it proved to be adenocarcinoma tubulare, limited to the submucosal layer.