菊花状を呈するⅡc＋Ⅱa型早期胃癌の1例

Ⅱc+Ⅱa Type of Early Gastric Cancer Looking Like Chrysanthemum Petals, Report of a Case

　われわれは，胃X線・内視鏡検査で，その形を正確に把えることができたⅡc＋Ⅱa型早期胃癌の1例を報告する．この症例のⅡc＋Ⅱa型早期癌は，Ⅱc部分の面積がⅡa部分より広いから単にⅡc＋Ⅱa型とするのではなく，佐野が指摘したような種々の特徴を持つ型と考えられるので，この点についても検討した．

　A 70-year-old man came to our hospital for detailed examination of the stomach as he was found to have abnormal findings in the course of gastric mass survery. General and physical examinations at admission revealed no abnormality. Roentgenography of the stomach showed obvious mucosal convergency on the posterior wall of the body. In its center was seen a granular shadow. The radiating mucosal folds became gradually wider and at the margins of the lesion they looked like petals of a flower. Endoscopically the marginal part was elevated and looked white, a finding suggestive of a breaker along a beach. In the resected specimen the center of the converging folds was slightly depressed and the surrounding folds were elevated. The lesion was Ⅱc+Ⅱa type early cancer as proposed by Sano. This type of early cancer too often shows biphasic intramucosal proliferation of cancer: in the part of Ⅱa and that of Ⅱc, so that clinically it is apt to be erroneously diagnosed as advanced cancer or malignant lymphoma. In the accurate diagnosis of this type of cancer one should always bear in mind clinically possible presence of such a characteristic early cancer.