Radiological Study on the Gastric Carcinoma of the Fundic Gland Area Yasumasa Baba 1 , Hiroshi Shimizu 1 , Jun-ichi Tsumagari 1 , Mitsumasa Nishi 2 , Yo Kato 3 1Department of Internal Medicine, Cancer Institute Hospital 2Department of Surgery, Cancer Institute Hospital 3Department of Pathology, Cancer Institute Hospital pp.1011-1026
Published Date 1987/9/25
DOI https://doi.org/10.11477/mf.1403113000
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 Ninety-eight cases of gastric cancers (49 early and advanced types) of the fundic gland mucosa were studied with respect to radiological findings. These were the cases experienced at the Cancer Institute Hospital in 1981 through 1986.

 1. Size and depth of invasion of primary lesion  Primary lesion was 2cm in diameter or less in 64.3% (63/98) of the cases. In those cases, however, carcinoma was limited intramurally in only 27% (17/63).

 Thus, it may well be said that carcinomatous invasion exist deeper than the submucosa even when the primary lesion of the fundic gland is small.

 2. Sensitivity of the routine examination (by remote controlled x-ray TV apparatus)  Twenty-one cases (77.8%) of 27 cases were detected by this method, a comparable sensitivity for early gastric cancers as a whole. As for 12 cases of gastric cancers on the anterior wall, however, detection rate was lower 58.3% (7/12). Therefore, more accurate methodology is needed to detect cancers on the anterior wall by routine radiological examination.

 3. Diagnosis of depth of invasion  The following factors are helpful in determining radiologically whether the cancer is limited in the mucosa or not; (1) the degree of granulation on the surface of depression, (2) presence or absence of radiolucent area surrounding depressed lesion. The rate of submucosal invasion was high, 86.2% (25/29), when few granulations were seen. It was also high, 90% (18/20), when there was radiolucent zone surrounding the depression.

 4. Diagnosis on the boundary of infiltration in LP type carcinoma  (1) It tends to be thought that the more cancer infiltrates in the submucosa, the more it occurs along the vertical axis as well as along the horizontal axis resulting in the involvement of the entire stomach.

 (2) It is, therefore, imperative that even if the lesion looks like early cancer at a glance, the mucosal folds arround the lesion be fully examined radiologically.

Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.


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