Pathological Characteristics of Early Gastric Cancer with Intratumoral Ulceration Yasuharu Kaizaki 1 , Osamu Hosokawa 2 , Tamon Miyanaga 3 , Kenji Dohden 3 , Masakazu Hattori 3 , Yasuo Hashizume 3 , Hiroyuki Aoyagi 4 , Naoyuki Ibe 4 , Kouji Urasaki 1 1Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan 2Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan 3Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan 4Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan Keyword: 早期胃癌 , 病理 , 癌巣内潰瘍 , 内視鏡的粘膜下層剝離術 pp.7-15
Published Date 2013/1/25
DOI https://doi.org/10.11477/mf.1403113694
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 We analyzed the pathological features of EGC(early gastric cancer)with UL(ulceration in the cancer nest). In the examination of ESD(endoscopic submucosal dissection)specimens, the extent of fibrous tissue by biopsy scar was less than 2.7mm. In the examination of surgical specimens, true UL's showed fan-shaped forms of fibrous tissue that extended toward the muscularis propria from the muscularis mucosae. In intramucosal EGC, the spread of the fibrous tissue of the differentiated-type was greater than that of the undifferentiated-type and many lesions showed that fibrous tissue reached the muscularis propria. So, it is considered that ESD for the differentiated-type is difficult. In EGC with submucosal invasion, the differentiated-type showed massive submucosal invasion outside the fibrous tissue, and poor infiltration within the fibrous tissue. On the other hand, many lesions of the undifferentiated-type revealed diffuse infiltration within the fibrous tissue. When performing ESD for EGC with UL, we should carry out the treatment while being well aware of the pathological features.

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