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Cases Erroneously Diagnosed as Early Gastric Cancer are Described with a Few Personal View Regarding Their Endoscopic Diagnosis S. Sai 1,2 , H. Sata 2 , T. Usui 1 , K. Koizumi 1 , A. Ando 1 1Dept. of Surgery, School of Medicine, Showa University 2Medical Associated for Early Gastric Cancer Detection pp.289-298
Published Date 1971/3/25
DOI https://doi.org/10.11477/mf.1403111509
  • Abstract
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 1. Benign lesions easily mistaken for early gastric cancer.

 In the active stage of Ul-Ⅱ type acute kissing ulcers occurring in the preferential site of the pyloric antrum, its pathological patterns are so variegated that they are often misleading. The diagnosis of benign ulcer is fairly well made by accurate interpretation of each finding obtained. Ulcers reduced in size and in scarring stage may sometimes be confused with minute Ⅱc lesion, but their symmetrical existence on both sides of the wall is a substantial help to accurate diagnosis.

 RLH at times presents a confusing picture closely resembling Ⅱc lesion. In the former, the margin of the lesion cannot be followed through its whole circumference. The floor of depression and its surrounding mucosa look soft. Often seemingly malignant finding is intermixed with benign one.

 2. Early gastric cancer easily confused with benign lesion.

 Pedunculatecl lesion in adenomatous polyp is at times cancerous when it is more than 1.5 cm in greatest diameter. In a recent case over 2cm in greatest width, early gastric cancer was recognized in an exceedingly small part of it. Correct diagnosis was almost impossible even by biopsy.

 Most of Ⅱa-like protrusions caused by atypical epithelium are low elevations with flat surface, under 1 cm in diameter, belonging to type Ⅲ as classified by Yamada. The surface is smooth to uneven with slight discoloration. In certain cases it cannot be discriminated from early cancer even through biopsy.

 Minute Ⅱc lesion apt to be confused with erosion can be ascertained to a certain degree by 1) punchedout irregular depression and 2) raised mucosa around it. Of some help to its diagnosis as well is isolated appearance of Ⅱc lesion.


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

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

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