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要旨 患者は80歳代,男性.2001年1月に前庭部大彎に25mm大の隆起性病変が認められ,生検診断はGroup 3,腺腫で本人の希望により経過観察となった.経過中は形態的には大きな変化はみられず,生検診断でもGroup 3を繰り返したが,2009年の生検で初めてGroup 5,腺癌と診断された.高齢を理由に当初は経過観察を希望していたが,癌に対する不安感が徐々に強くなり,内視鏡的粘膜下層剝離術を施行した.一括切除が可能であり,最終の病理組織学的診断は,高分化管状腺癌,Stage IAであった.
An eighty-year-old male had been followed up because of a IIa-like elevated lesion in the antrum of the stomach, since 2001. Initially, histological findings of the biopsy specimen revealed adenoma, Group 3. Follow-up examination showed almost similar findings to those of the previous examination. In 2009, 9 years after the initial diagnosis, no morphological change was observed endoscopically, but the histological diagnosis of biopsy specimens revealed adenocarcinoma, Group 5. Endoscopic submucosal dissection(ESD)was performed. The final pathological diagnosis was a well differentiated adenocarcinoma at mucosal-layer depth.
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