U字形を呈したⅡc型早期胃癌の1例

Ⅱc Type Gastric Carcinoma of U-shape, Report of a Case

要旨　特異な形態のⅡc型早期胃癌を報告した．31歳，女性．人間ドックを受診し，胃X線検査で異常を指摘された．胃X線精密検査および内視鏡検査により前庭部前壁に大彎側に開いたU字形の線状陥凹を認め，開いたそれぞれの先端に小陥凹をみた．U字形陥凹内の粘膜は近傍の粘膜と粘膜模様，高さに差を認めなかった．病理学的に病変は13×11mm，深達度m，低分化腺癌であり，U字形陥凹内の粘膜は再生上皮ではなく，幽門腺粘膜より成り，癌は認められなかった．

　A 31-year-old woman was pointed out to have an abnormality at our gastric mass survey and received further examinations in January 1985. Roentgeno-graphic and endoscopic examinations revealed U-shaped depression in the anterior wall of the antrum. The lesion was demarcated by sharp and irregular margin. The area surrounded by U-shaped depression had normal structure of area gastricae as seen in the other area of the antrum. The lesion was diagnosed as the unusual form of Ⅱc type early carcinoma and the presence of adenocarcinoma was confirmed by biopsy. Subtotal gastrectomy was performed on April 10, 1985. Observation of the resected specimen showed lesion of U-shape, measuring 1.3×1.1 cm in size, in the anterior wall of the antrum. Cancer tissue, however, had not invaded in the area surrounded by U-shaped depression. Histological examination showed poorly differentiated adenocarcinoma limited to the mucosal layer without lymph node metastasis.