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要旨●患者は50歳代,女性.検診の上部消化管X線造影検査で胃に異常を指摘された.EGDで同部に病変を認めたため,精査・加療目的で当院に紹介され受診となった.EGDにて胃体上部大彎に径25mmの周囲にconverging foldと,中央に溝状の陥凹を有する発赤調の表面平滑な隆起性病変を認めた.NBI拡大観察では腺窩構造の開大とシアン調の拡張血管を認めた.同部の生検にて神経内分泌腫瘍G1と診断された.腹腔鏡下噴門側胃切除術を施行し,胃NET,G1,pT4,pN1,M0,Stage IIIの診断であった.
A woman in her 50s with a gastric tumor detected in the upper gastrointestinal series was referred to our hospital for detailed evaluation and treatment. Esophagogastroduodenoscopy revealed a submucosal tumor of 2.5cm in diameter with bridging folds in the greater curvature of the upper stomach. In addition to a smooth, reddish surface, the tumor had a groove-like depression at its center. Magnified narrow-band imaging revealed enlargement of crypts and cyan dilated vessels on its surface. The tumor was diagnosed as a NET(neuroendocrine tumor)G1 by forceps biopsy. Radical laparoscopic proximal gastrectomy was performed. Histopathological diagnosis confirmed gastric NET G1, T4N1M0, stage III, based on the American Joint Committee on Cancer/Union for International Cancer Control 8th edition staging system.
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