広範囲隆起性早期胃癌の1例

Extensive Early Gastric Cancer of Protruded Type, Report of a Case

　肉眼的に一見メネトリエ病の所見を呈し，病理組織学的には広範囲の早期胃癌であった興味ある症例を経験したので報告する．

症　例

　患　者：57歳　男子

　主　訴：心窩部痛

　家族歴：特記すべきことなし．

　既往歴：昭和15年，気管支喘息．

　現病歴：10年来，時々心窩部痛があり，3カ月位前より，食欲不振，全身倦怠感，体重減少をともなうようになり当内科受診．

　The patient, a man aged 57, with a chief complaint of pain in the upper abdomen of ten years' duration, visited our clinic in the Department of Internal because since three months before he had loss of appetite, general malaise and weight loss. Both physica and serologic examinations revealed no abnormalities. Roentgenologic study of the stomach showed an extensive lesion spread from the mid-corpus over the angle down to the pyloric antrum. At places the areae gastricae were rough and enlarged with a suggestion of mucosal hypertrophy. As endoscopically similar findings were obtained, either benign polyposis of the stomach associated partially with cancer, extensive elevations due to malignant lymphoma or multiple Ⅱa lesions were suspected. Histologic diagnosis of biopsy specimens taken chiefly from the elevated lesions was multiple Ⅱa type cancers including some with less atypicality as findings of Groups Ⅲ, Ⅳ and Ⅴ were obtained. Resected specimen showed an extensive lesion including a portion looking at a first glance like Ménétrier's disease. Histologic study of the complete sections of the specimen showed that it contained a border-line change between benignancy and malignancy along with extensive early cancer of the protruding type, partially invading the submucosa, in all probability caused by multicentric evolution of gastric cancer.