特徴的な内視鏡像を呈した粘膜下異所性胃腺に連続進展したと考えられた早期胃癌の1例 Gastric intramucosal cancer spreading to submucosal heterotopic gastric glands

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著者

    • 田中 宏樹 TANAKA Hiroki
    • JA三重厚生連鈴鹿中央総合病院消化器内科 Department of Gastroenterology, JA Suzuka General Hospital
    • 佐瀬 友博 SASE Tomohiro
    • JA三重厚生連鈴鹿中央総合病院消化器内科 Department of Gastroenterology, JA Suzuka General Hospital
    • 岡野 宏 OKANO Hiroshi
    • JA三重厚生連鈴鹿中央総合病院消化器内科 Department of Gastroenterology, JA Suzuka General Hospital
    • 向 克巳 MUKAI Katsumi
    • JA三重厚生連鈴鹿中央総合病院消化器内科 Department of Gastroenterology, JA Suzuka General Hospital
    • 渡辺 玄 WATANABE Gen
    • 新潟大学大学院医歯学総合研究科分子診断病理学分野 Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Science, Niigata University

抄録

73歳男性.胃体上部小彎に0-IIa+IIc病変を認め,早期胃癌(tub1, SM)の診断で胃部分切除術を施行した.病理組織学的検討では粘膜内を中心に小腸型形質を示す高分化型管状腺癌が認められ,一部病変内には粘膜筋板を保ったまま粘膜下層内への進展も認められた.粘膜下層内病変は間質反応に乏しく,全周にわたり粘膜筋板と連続した平滑筋組織が認められた.以上より粘膜下異所性胃腺に連続して進展した早期胃癌と診断した.

A 73-year-old man was referred to our hospital for further examination of an intra-abdominal mass. An upper gastrointestinal endoscopy revealed a 0-IIa+IIc lesion on the lesser curvature of the middle body. The lesion was diagnosed as early gastric cancer (tub1, SM), and a partial gastrectomy was performed. Pathological evaluation revealed a well-differentiated intramucosal adenocarcinoma that had partially spread to the submucosa. On immunohistochemical examination, the lesion displayed an intestinal phenotype. The submucosal lesion had poor stromal reaction, and there was smooth muscle tissue surrounding the lesion. As mentioned earlier, we diagnosed the lesion as a gastric intramucosal cancer spreading to the submucosal heterotopic gastric glands.

収録刊行物

  • 日本消化機病學會雜誌. 乙

    日本消化機病學會雜誌. 乙 112(9), 1657-1663, 2015

    The Japanese Society of Gastroenterology

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