内容紹介
Summary
A Japanese man in his 60s presented with complaints of epigastric pain and weight loss. A gastrointestinal endoscopy revealed multiple gastric ulcers and an irregular mound located on the wall of the lower gastric body along the greater curvature, which was suspected to be cancerous. A biopsy revealed that it was a Group 2 tumor even though the biopsy was repeated 4 times. He was referred to our hospital and 3 biopsies were performed. The final result classified the tumor as Group 4. The patient underwent surgery and the pathological examination revealed an extremely well-differentiated adenocarcinoma(EWDA). An EWDA is characterized by a well-formed mucinous gland with little or no nuclear atypia, which makes preoperative biopsy diagnosis difficult.
要旨
症例は60歳台,男性。腹痛,体重減少を主訴に前医を受診し,胃に多発する潰瘍性病変を指摘された。胃体下部大弯の病変は胃癌が疑われ4回生検が行われたが,結果はGroup 2であった。精査加療目的で当院に紹介となった。当院でも3回生検が行われ,最終的にGroup 4と診断された。幽門側胃切除術を施行した。病理組織学的検査結果は腸型超高分化型腺癌(pT3N0M0,pStage ⅡA)であった。超高分化型胃癌は細胞異型が乏しいため,生検による術前診断が困難な場合もある。本症例では計7回の生検を行い胃癌と診断された。
目次
A Japanese man in his 60s presented with complaints of epigastric pain and weight loss. A gastrointestinal endoscopy revealed multiple gastric ulcers and an irregular mound located on the wall of the lower gastric body along the greater curvature, which was suspected to be cancerous. A biopsy revealed that it was a Group 2 tumor even though the biopsy was repeated 4 times. He was referred to our hospital and 3 biopsies were performed. The final result classified the tumor as Group 4. The patient underwent surgery and the pathological examination revealed an extremely well-differentiated adenocarcinoma(EWDA). An EWDA is characterized by a well-formed mucinous gland with little or no nuclear atypia, which makes preoperative biopsy diagnosis difficult.
要旨
症例は60歳台,男性。腹痛,体重減少を主訴に前医を受診し,胃に多発する潰瘍性病変を指摘された。胃体下部大弯の病変は胃癌が疑われ4回生検が行われたが,結果はGroup 2であった。精査加療目的で当院に紹介となった。当院でも3回生検が行われ,最終的にGroup 4と診断された。幽門側胃切除術を施行した。病理組織学的検査結果は腸型超高分化型腺癌(pT3N0M0,pStage ⅡA)であった。超高分化型胃癌は細胞異型が乏しいため,生検による術前診断が困難な場合もある。本症例では計7回の生検を行い胃癌と診断された。