深達度smと術前に正診できたⅡa＋Ⅱc型早期胃癌の1例

Early Gastric Cancer, Type Ⅱa+Ⅱc, with Submucosal Involvement, Report of a Case

症例

　患　者：50歳，男，会社員．

　現病歴：1977年5月，ドック検査で胃癌を疑われ，6月入院．自覚症状はない．

　An asymptomatic 50-year-old man came to our clinic with abnormality of the stomach detected at a gastric mass survey. A small irregular-shaped barium patch and surrounding radiolucency on the posterior wall of the gastric antrum were visualized on the double contrast views. At the compression study, the shape of barium patch was not altered by either light or strong pressure. At gastroscopy, an irregular-shaped depression covered with spotty white coat was visualized on the posterior wall of the antrum. Preoperatively, the patient was diagnosed as having a sm early cancer from its radiological feature that the shape of depression was not altered by either light or strong compression, and gastrectomy was carried out.

　Ⅱa+Ⅱc type early gastric cancer 18×15 mm in diameter was noted in the resected specimen. Massive infiltration of well differentiated tubular adenocarcinoma into the submucosal layer nearly equal to the extent of intramucosal involvement was microscopically recognized. Tubular adenocarcinoma was seen in the lymphatic vessels of the submucosal layer and regional lymph node metastasis was also encountered.