A Case of Early Gastric Cancer Diagnosed as Concomitant Ⅱb-like Lesion E. Ochiai 1 , S. Nakazawa 1 , M. Ishiguro 1 , H. Nakano 1 , R. Hayakawa 2 , K. Kobayashi 2 , T. Kato 3 12nd Dept. of Int. Med. Nagoya Univ. Sch. of Med 2The Center for Health Care of Aichi 3Kato Clinic pp.211-216
Published Date 1974/2/25
DOI https://doi.org/10.11477/mf.1403111752
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 The patient was a 58-year-old man.There was nothing to contribute in family history, past history, physical examination and laboratory reports. Abnormal finding was detected in gastric mass survey. After close examination of radiograph and endoscopy, he was diagnoed as Ⅱb+Ⅱa+Ⅱc type of early gastric cancer. Gastric biopsy showed positive result. In the resected specimen, the lesion mesured 6.5×10.0 cm. The mucosa of Ⅱb had the mixed appearance of slight protrusion and flatness. In the area of Ⅱb, no remarkable unevenness was observed with surrounding normal mucosa and the area was diagnosed as concomitant Ⅱb-like lesion. It was histologically adenocarcinoma tubulare with m degree invasion as a whole, but with partial slight sm invasion in Ⅱc area. Final diagnosis was early gastric cancer of Ⅱb+Ⅱa+Ⅱc type mainly occupied by Ⅱb-like lesion.

 In this case, x-ray findings of Ⅱb-like lesion were as follows. The lesion could be visualized most clearly in double contrast radiograph. In comparison with the surrounding normal mucosa, Ⅱb-like lesion showed an image of assembly of lower protrusions than that of Ⅱa type early cancer. It looked like an assembly of the round transparent shadows, which were circumscribed by irregular ditches. The width of each ditch was varied. As a whole image of the x-ray finding, the mucosa of Ⅱb-like lesion seemed as if gastric areas were oppressed to flat.

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