胃生検で診断しえた微小胃癌

A Minute Gastric Cancer Detected by Biopsy, a Case Report

患者：58歳　男

病歴：来院の2週間前より上腹部鈍痛を訴え，他医で胃X線検査をうけ，胃内視鏡検査の必要ありと言われて本院を受診した．

　The patient: a 58-year-old man.

　Present illness: As he had been complaining of dull pain in the epigastrium, he was referred to us for thorough check-up.

　X-ray findings: Upright, barium-filled picture revealed deformity of the angle with lessened distensibility of the lesser curvature. Slight unevenness was also noticed there in double contrast picture together with barium flecks with irregular margins.

　Endoscopic findings: On the anterior wall close to the antral lesser curvature below the angle were seen small depressions and reddened spots. Seven specimens for biopsy were taken from there.

　Histological findings of biopsied specimens and diagnosis: Differentiated tubular adenocarcinoma (group Ⅳ) was demonstrated in one of them.

　Gross observation of the surgical specimens: Two thirds of the stomach was excised. A minute ulcer surrounded with shallow depressions was seen on the anterior wall near the lesser curvature, but any cancer spread could not be grossly recognized.

　Histological observations and diagnosis: An infinitesimal cancer lesion 0.8 mm in diameter was demonstrated in one of semi-serial sections, each 0.5 cm in breadth, cancer tissue was located on the margins of a Ul-Ⅱ ulcer in the center. It was adenocarcinoma tubulare, CAT I, SAT 1, INFα, m, Ul-Ⅱca.

　It is in the diagnosis of minute cancer that gastric biopsy can fulfill one of its most important roles.