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Pathology of Ⅱa+Ⅱc Type Early Gastric Cancer Yuzo Maruyama 1 1Central Clinical Laboratories, Shinshu University Hospital pp.1689-1698
Published Date 1971/12/25
DOI https://doi.org/10.11477/mf.1403111419
  • Abstract
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 The so-called Ⅱa+Ⅱc early cancer of the stomach is more interested because of its characteristic appearance and early invasive growth. Its frequency among all types of early gastric cancer is estimated as 5.5 to 7.0 per cent, although its interpretation is somewhat different according to the criteria of examining institutions. The lesion of Ⅱa+Ⅱc type mostly develops on the antral mucosa in persons in the 6th and 7 th decades of age.

 Pathologically, its typical gross appearance is divided into two groups. The one is a flat polypoid growth with box-like elevation of the muscularis. The malignant cells spread to the surrounding elevated area and submucosal invasion is not so frequent. The others likely show the box-like elevation of the muscularis rnucosae, but malignant change is limited within the central Ⅱc area. The surrounding benign mucosa forms a core at an acute angle on both sides. Histologically, papillary adenocarcinoma with clearcytoplasmic cells is in most but solid medullary carcinoma are also observed. Both tend to invade the submucosa in earlier stage of cancer development. The former is more apt to show vascular invasion. Further observations not only on this type of early cancers but also on advanced carcinomas of the same variety revealed that the structure of solid medullary carcinoma in these cases was partly intermixed with papillary adenocarcinoma with clear-cytoplasmic cells. Vascular invasion was remarkable together on both caces so that histologically they appear to be of fairly approximate nature. Since clear cells are scattered about in many tubuli as Paget's cells in the mucosa of some Ⅱa+Ⅱc lesions with submucosal papillary growth of clear cells alone, these mucosal cells are of interest as representing yet an earlier stage of this type of early cancer.

 Reference has also been made to an assumption that Borrmann type Ⅱ advanced cancer with marked vascular invasion may possibly develop from this variety. Reported are also some cases of verrucous gastritis simulating Ⅱa+Ⅱc lesion.


Copyright © 1971, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

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