印環細胞癌を伴う0-I型低異型度分化型胃癌の1例

A Type 0-I Low-grade Differentiated-type Adenocarcinoma with Several Signet Ring Cell Components, Report of a Case

要旨●患者は60歳代，男性．前医のスクリーニング上部内視鏡検査で胃体上部後壁に隆起性病変を指摘されたため，当科へ紹介され受診となった．病変は当院で4年前に胃過形成性ポリープと診断したものと同一病変であったが，増大傾向がみられたために生検を施行したところ，印環細胞癌を認めた．診断的治療目的に内視鏡的粘膜下層剝離術（ESD）を施行し，切除標本を病理学的に検討した結果，最終的に印環細胞癌を伴った0-I型低異型度分化型胃癌と診断した．

　A patient in his 60s was referred to our hospital because his endoscopy findings revealed a type 0-I tumor located on the superoposterior wall of the upper gastric body. Four years ago, on histological analysis, the same lesion was diagnosed as a hyperplastic polyp. This time, we conducted secondary biopsy examination of the lesion because it seemed to have grown slightly. Histological analysis revealed a signet ring cell carcinoma. Then, we performed endoscopic submucosal dissection for therapeutic diagnosis and finally diagnosed the lesion to be a low-grade differentiated adenocarcinoma with several signet ring cell components.