症例5 23歳（♀）の早期胃癌

A Case of Early Gastric Cancer in a 23-Year-Old Female

　患　者：○谷美　23歳　♀

　現病歴

　昭和45年5月，突然吐血，某病院に入院，輸血600cc受く，昭和45年7月，X線・内視鏡検査施行，異常を指摘されなかった（retrospectiveにはⅡc様病変を認める）．昭和45年9月，再び吐血し，輸血1,000ccを受け，昭和46年4月，下血と貧血に気づき，某医でX線検査の結果，胃潰瘍を指摘された．その直後再び吐血，下血あり，Subshock状態で当科に緊急入院．

　A 23 years old nurse has experienced thrice recurrent bouts of hematemesis. In April 1971 she was admitted to our hospital with melena, anemia and hematemesis. X-ray pictures revealed an irregular shallow ulceration on the anterior wall of the middle corpus. Endoscopic examinations by GTF-A also disclosed there definite Ⅱc findings such as mucosal convergency towards the lesion and tapering of the folds with islet-like mucosal residues. By biopsy the lesion was diagnosed as adenocarcinoma tubulare mucocellulare, and cytologically it was class Ⅴ.

　A few days later subtotal gastrectomy was done. Resected specimen showed an irregular Ⅱc lesion on the anterior wall of the middle corpus. It measured 2.5×3.8 cm. Histopathologically, the carcinomatous infiltration was limited within the mucosal layer and unaccompanied with surface ulcertion. There was no regional lymph node metastasis.