Ⅱc内に多発潰瘍および瘢痕を認め，著明なfibrosisを伴った大彎側sm胃癌の1例

Early Gastric Cancer (sm) with Multiple Ulcers and Scars in the Ⅱc Erosion with Marked Fibrosis (Submucosa) on the Greater Curvature, Report of a Case

　われわれはⅡc内に大彎線と直行して並ぶ3個の多発潰瘍および瘢痕のために，大彎側の陥凹所見が強く，更に粘膜下層のfibrosisが著明なために，術前診断でpm以下の進行胃癌とした，大彎側Ⅱc型早期癌（sm）を経験したので報告する．

　A 50-year-old farmer visited our hospital because of epigastralgia. We found ulcerative lesion on the greater curvature by x-ray; especially marked excavation was revealed by upright filling picture and double contrast study, and a highly radiolucent lesion surrounding it was recognized as irregular barium fleck by compression study. We diagnosed this lesion as advanced cancer with pm or more pm depth invasion, as a final conclusion before operation.

　Histologically, this lesion was Ⅱc type early cancer, and elevated scars were recongnized on both ends of Ⅱc erosions, and between their scars, an ulcer (Ul-Ⅱ) was seen. Marked fibrosis was noted in the submucosa of this Ⅱc area. Histological type of cancer was poorly differentiated adenocarcinoma. Cancer invasion was limited to the submucosa.

　Retrospectively, deformation of this lesion was stressed and exaggerated, because of lesion on the greater curvature, and elevated scars which could never be found in advanced cancer was recognized, therfore, it seemed that diagnosis of early gastric cancer (sm) could be posible about this case.