早期胃癌Ⅱa＋Ⅱcの1例

Ⅱa+Ⅱc Type Early Gastric Cancer, a Case Report

はじめに

　これまで幸いかなり数多くの早期胃癌症例を経験することができた．日頃痛感することであるが，X線検査にしても，内視鏡検査にしても，数少ない人間で常にレベルをピークに保って症例を待機していることはたいへん難しいように思う．症例によってはくり返し検査することからして困難なことがある．この例は家庭の都合上ゆっくり検査している余裕がなく，早々に手術した症例で，検査不充分の点が少なくない．しかしそれだけに，唯一の機会をも逃がさない網の目の細かさの必要を感じさせられた．

　Case: a 59 year-old male, having no past history or subjective symptom referable to the present disease.

　While in x-ray study early gastric cancer was strongly suspected by a prone barium-filled picture, gastroscopic examination disclosed more striking changes as of gastritis in the antrum. Endoscopy revealed as well a depressed area at the angle already considered suspicious by x-ray, but it was impossible then to decide that the depression at the incisura was of the nature of Ⅱa+Ⅱc.

　Biopsy under direct vision of various areas of the stomach, including the depressed region visualized by FGS, led the authors to the diagnosis of cancer within a short time.

　It is described here that pathologic changes of early gastric cancer, when located on the uneven and rough mucosal surface as in this case, are sometimes endoscopically hard to grasp and interprete accurately. On encountering another similar case, the authors are prepared to investigate it as well by other procedures such as, for instance, intragastric pressure measurement.