治癒潰瘍の辺縁にみられたReactive lymphoid hyperplasiaを伴なった微小胃癌の1例

A Case of Minute Early Cancer of the Stomach Seen on the Margins of a Healed Ulcer and Accompanied with Reactive Lymphoid Hyperplasia

　Ul-Ⅱの治癒潰瘍の辺縁にみられたReactive lymphoid hyperplasiaを伴なった微小胃癌で，組織学的には悪性リンパ腫を疑わせた興味ある一例を経験したので報告する．

　At a mass screening for gastric diseases, a man aged 41 was sdvised to undergo a thorough check-up because of deformity of the angulus found thereby.

　Examination of the stomach by x-ray and endoscopy was suggestive of Ⅱa+Ⅱc early gastric cancer along with a healed ulcer. Biopsy revealed atypical cells scattered about in the lymphatic tissue. First, reticulum cell sarcoma was suspected, but finally a diagnosis of carcinoma simplex was made because of the staining tendency of tumor cells. Gross observation of the resected specimen showed a shallow depression on the anterior wall near the angle. At the end of the converging mucosal folds was seen a mucosal defect, 0.2×0.2 cm in size, adjoined by an elevation measuring 0.7×0.7 cm. Histologically, the depression was a healed ulcer with a degree of Ul-Ⅱ, and nearby on a part of the elevation was recognized a minute cancer, carcinoma simplex, accompanied with lymphoid hyperplasia with a small ulcer in the center. The extension of cancer over the mucosal surface was very confined, showing an early cancer of PEN type, forming Ⅱa+Ⅱc. Lymphoid hyperplasia seen in this case should best be regarded as of reactive, secondary nature accompanying cancer infiltration. It was also of great interest that a minute cancer developed on the margin of a healed ulcer.