A Comparative Study between Radiologic and Macroscopic Findings of Early Gastric Carcinoma with Ⅱb-like Intramucosal Spread: With special reference to radiologic definition of proximal boundary Y. Baba 1 , N. Sugiyama 1 , M. Maruyama 1 , K. Nakamura 2,3 , K. Kumakura 4 1Department of Internal Medicine, Cancer Institute Hospital 2Dept. of Pathology, Cancer Institute 4Dept. of Diagnostic Radiology, Keio University School of Medicine pp.1087-1103
Published Date 1977/8/25
DOI https://doi.org/10.11477/mf.1403112601
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 The above mentioned study was conducted in order to define radiologically a boundary between Ⅱb-like lesion and the normal surrounding mucosa, based upon 71 such cases which had been obtained in the period of 11 years from 1965 to 1976 at the Cancer Institute Hospital. Especially, an analysis was focused upon correlation between radiologic sign and histologic type of the lesion at its proximal boundary. For analysis of the radiologic findings double contrast radiograph were mainly used. Histologic type of gastric carcinoma was divided into two basic types, namely differentiated carcinoma (Intestinal type) and undifferentiated carcinoma (Gastric type). Following results were obtained.

 1. The histologic type was found to be related closely to the radiologic sign in 60% of the Ⅱb-like lesions. In such cases, the proximal boundary was easily defined. 2. A linear shadow of barium which was retained in between the mucosal folds was found to be an aid for defining the proximal boundary. 3. In the lesions which showed characteristic radiologic sign of each histologic type with easily defined boundary, histologic examination revealed numerous minute erosions and these erosions were found more frequently in the undifferentiated carcinomas than the differentiated carcinomas. 4. In addition to defining the proximal boundary for determining surgical cut line, an attention should be paid to a presence of a satellite focus which was located whithin 1 cm of the surgical stump, because 15 such foci were discovered in 125 cases of multiple cancers which were experienced in the recent 6 years.

Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.


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