初回検査時に原発巣の目立たない症例―比較的急速に悪化し死亡した症例

Rapidly Developing Linitis Plastica Resulting in Early Deterioration and Death, Report of a Case

　患　者：K. T.，23歳，女．

　1975年2月，食後の上腹部鈍痛，胃のもたれ感，背痛を訴え外来を訪れ，胃X線検査，胆のうX線検査，血液化学検査などを行ったが，ほとんど異常なしと判定された．

　その後，1年1カ月の間にときどき上腹部不快感，背部痛などを訴え2度ほど外来を受診しているが，理学的所見に異常を認めていない．

　A 23 year-old female patient complained of epigastric pain. Radiographic examination revealed nothing suspicious. An examination 13 months later confirmed the disease as cancer. The patient died two months after the diagnosis. Viewing the initial radiographic retrospectively the initial lesion was seen as a tiny niche on the posterior wall of the corpus or fundic glandular area.

　This case illustrates three points :

　1. At the time of the initial examination, it was deduced that the cancer had already extensively spread beyond the submucosal layer.

　2. The diagnosis determined that the ulcer had grown very rapidly, even though it had been formed on the surface of linitis plastica.

　3. The patient died 15 months after the initial examination. We can conclude that the growth of linitis plastica in the submucosal layer is far more rapid than in the mucosal layer.