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Elevated Type of Gastric Cancer Formed by Non-solid Poorly Differentiated Adenocarcinoma, Report of a Case Eiji Ikeda 1 , Yasuhiro Oono 1 , Takeshi Kuwata 2,3 , Hiroyuki Shitara 4 , Nozomu Fuse 1 , Takashi Kojima 1 , Keiko Minashi 1 , Hiroaki Ikematsu 1 , Tomonori Yano 1 , Takayuki Yoshino 1 , Makoto Tahara 1 , Toshihiko Doi 1 , Mitsuo Satake 4 , Atsushi Ochiai 2,3 , Kazuhiro Kaneko 1 , Atsushi Ohtsu 1 1Department of Gastroenterology, National Cancer Center Hospital East, Kashiwa, Japan 2Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan 3Department of Clinical Laboratory, National Cancer Center Hospital East, Kashiwa, Japan 4Diagnostic Radiology, National Cancer Center Hospital East, Kashiwa, Japan Keyword: 1型胃癌 , 非充実型低分化腺癌(por2) , 中分化管状腺癌(tub2) , NBI観察 , 肉芽組織 pp.1435-1445
Published Date 2012/8/25
DOI https://doi.org/10.11477/mf.1403113580
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 A 67-year-old woman diagnosed with type 1 gastric cancer at a nearby hospital presented to the National Cancer Center Hospital East. Gastric radiography showed a type 1 tumor in the great curvature of the middle body of the stomach. A lesion of 35mm in diameter with a steep, raised edge was surrounded by a shallow depressed area. Upper endoscopy confirmed a reddish, elevated lesion of 40mm in diameter that was partially covered with whitish mucus and surrounded by a discolored and shallow, depressed area in the great curvature of the middle body of the stomach. The entire lesion was elevated, presumably because of submucosal invasion. Magnifying endoscopy with narrow band imaging revealed thick, network-like vessels without caliber irregularity in the elevated lesion, and thin, corkscrew-like vessels accompanying the lesion with caliber irregularity in the surrounding depressed area. Poorly and moderately differentiated adenocarcinomas were detected at biopsy in the elevated and depressed areas, respectively. Since the tumor was thought to have invaded the muscularis propria, distal gastrostomy and D2 lymph node dissection were performed. Pathological examination of the resected specimen revealed that most of the elevated lesion was composed of poorly differentiated adenocarcinoma(non-solid type), and that moderately differentiated adenocarcinoma existed partly in the mucosal layer. The elevated lesion was formed by the submucosal proliferation of poorly differentiated adenocarcinoma cells with marked interstitial fibrosis. The surface of the elevated lesion was covered with granulation tissues containing many blood vessels. Non-solid type of poorly differentiated adenocarcinoma rarely forms elevated gastric cancer lesions without ulcer formation. Therefore, we describe the radiographic, endoscopic and pathological findings of this case with reference to the literature regarding this type of gastric cancer.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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