表層拡大隆起型胃癌例

Superficial Spreading Elevated Early Gastric Cancer, a Case Report

　一般に広い隆起型の早期胃癌は比較的少ない．たとえば，表層拡大型胃癌という型の早期胃癌は普通Ⅱc型であり，早期胃癌分類でⅡa型を呈し，6cmを越える症例はむしろ珍しいとさえいえる．

　われわれは術前に広いⅡaとⅡc＋Ⅱbを合併し早期胃癌と診断し，手術の結果進行癌であった，きわめて多彩な所見を示した1例を経験したので報告する．

　Superficial spreading type of early gastric cancer mostly belongs to the IIc subtype and widely elevated early cancer is relatively rare. Of cases of superficial spreading type of early gastric cancer measuring more than six cm in the largest diameter encountered in the Second Department of Internal Medicine, College of Medicine, Nagoya University, 10 cases showed elevated lesions as the chief finding of early cancer. Grossly they were divided into those with ulcer and those without any trace of ulcer. The latter was very few in number. One of these cases is reported here. Before the operation we made a diagnosis of early gastric cancer wtih protruded lesions accompanied with findings of IIc＋IIb, but the results of surgical correction showed that a part of the elevated changes invaded deeply in the vertical direction and most of lymphatic vessels in the submucosal layer beneath the cancer nest were occupied by cancer tissue.