微小Ⅱa型早期胃癌の1例―生検標本採取部位の決定に関連して

Very Small Type Ⅱa Early Gastric Carcinoma, Report of a Case

Ⅰ．症例

　患者：佐○淑○　54歳　女．

　主訴：腹部不快感，食欲不振．

　現病歴：昭和44年1月頃から，腹部不快感や食欲不振が続いていた．8月に入り，下腹部痛がおこり，8月8日当科受診．

　既往歴：腸チフス（16歳），虫垂炎後腹膜炎（29歳）．膀胱ポリープ（53歳）．

　家族歴：母親が胃癌で死亡．

　A type Ⅱa mucosal carcinoma of the stomach, measuring 6×4 is reported.

　The cancerous focus was confirmed by direct vision biopsy. Punch biopsy carried out in the light of x-ray findings led the authors to correct diagnosis, although fibergastroscopic diagnosis made during the examination was benign polyp.

　For making a correct diagnosis, it is very important to show the actual shape of a lesion on radiographs and to interpret accurately x-ray findings thus obtained.

　A sequence of examinations in order of x-ray, gastrocamera, gastrocamera with fibergastrorcope and direct vision biopsy as well as cytology is of great account for getting accurate information about the nature of a lesion.

　To interpret minute unevenness in a radiolucency at x-ray and whitish exudate over a small lesion at endoscopy is of great value in the improvement of preoperative diagnosis of gastric cancer. Accurate determination of target site of biopsy is a prerequisite for correct diagnosis of gastric cancer.

　The size of the cancerous focus is 2×2 mm.