A Case of Ⅱc+Ⅲ Type Early Gastric Cancer Co-existent with Localized Lymphoreticular Hyperplasia T. Takeuchi 1 , N. Kato 1 , H. Murate 1 , A. Tanabe 1 , M. Kataoka 2 1The First Dept. of Int. Med. Medical, School, Nagoya City University 2The Second Dept. of Surgery, Medical, School, Nagoya City University pp.1557-1562
Published Date 1971/11/25
DOI https://doi.org/10.11477/mf.1403111448
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 A 54-year-old man visited the authors' clinic complaining of epigastric pain. X-ray study of the stomach revealed on the posterior wall of the lower body a barium shadow fleck suggesting of an ulcer with distinct marginal borders extending almost in its whole circumference, although slightly ill-defined on the cardiac side. The lesion was visualized by endoscopy at the same site as a relatively shallow ulcer with irregular margins. The ulcer with its surrounding area was elevated as a whole, and elevations gradually and gently merged into the encircling normal mucosa. Contiguous to the lesion, its oral mucosa was discolored in some parts looking as if cancer infiltration had extended there. Gross specimen of the removed stomach disclosed at a site about 7cm oral from the pyloric ring a relatively deep ulcer, measuring 10×10 mm, neighbored still on its oral side by a shallow depressed lesion which measured 15×10 mm. Histologically, a localized tumor formation (adenocarcinoma acinosum), measuring 10 mm in its greatest diameter and localized within the submucosa, was seen in the site corresponding to the deep ulcer. Tumor cells and lymphoreticular hyperplasia were well intermixed. The adjacent lesion on the oral side, a shallow depression, was tubular adenocarcinoma localized within the mucosa. The whole picture constituted Ⅱc+Ⅲ type early gastric cancer coexistent with localized lyrnphoreticular hyperplasia. In Japan so far only four such cases including the present one have been reported. As histologically this lesion shows a structure to be called “medullary carcinoma with lymphoid stroma”, prognosis of this variety is considered favorable. Finally, reference has been made to a possible development pattern of the lesion.

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