胃巨大皺襞に1型早期癌を合併した1例

A CASE OF TYPE I EARLY GASTRIC CANCER ASSOCIATED WITE GIANT RUGAE OF THE STOMACH

Ⅰ．はじめに

　胃診断学の発達に伴ない，胃巨大皺襞の症例も漸次増加の傾向にあるが，最近われわれは胃体部皺襞大彎の巨大皺襞と前庭部大彎の1型早期胃癌と別個に認めた興味ある症例を経験したので，報告する．

　The patient, a 47 year-old-man, was found in a gastric mass survey to have giant rugosity of the stomach, so that despite the lack of any subjective complaint, he had to undergo a thorough check-up of his stomach. Roentgenologically the contour of the greater curvature of the corpus was irregular associated with hypertrophic, serpentine gastric mucosal folds. Apart from this, a shadow defect with uneven marginal irregularity was observed near the lowest pole on the greater curvature. Endoscopically an uneven, protruded lesion was found in the greater curvature side of the antrum in addition to giant rugae on the greater curvature of the body. Cytology under direct view of the protruded lesion in the antrum confirmed it as belonging to Class Ⅳ. Operation was accordingly performed. Resected stomach showed that on the anterior and posterior walls across the greater curvature of the body, there was abnormal, though relatively localized, hypertrophy of the mucosal wall as well as a protruded lesion measuring 2 by 2cm on the greater curvature of the antrum. The latter, as yet remaining in the stage of early cancer, proved to be adenocarcinoma tubulare with the degree 1 of depth invasion. Marked tortuosity of the mucosal folds was observed in the area of giant rugosity with prolongation of the lining of gastric pits and cellular infiltration in the interstitium. No metastasis was found in any of lymphnodes examined.