Aoyagi Keishiro, Koufuji Kikuo, Yano Shojiro, Miyagi Motoshi, Koga Atsuhiko, Takeda Jinryo, Shirouzu Kazuo
Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume City, Fukuoka 830-0011, Japan.
Kurume Med J. 2003;50(1-2):49-51. doi: 10.2739/kurumemedj.50.49.
We have experienced a case of small early mucosal gastric cancer with lymph node metastasis. The patient was a 75-year-old woman diagnosed as having early gastric cancer type 0 IIa on the greater curvature of the antrum. We performed distal gastrectomy, with Billroth I method reconstruction. The tumor lesion was on the greater curvature of the antrum. Metastasis was discovered in the number 4d lymph node, histologically. The tumor was type 0 IIa confined to the mucosa, 1.0 cm in diameter and differentiated histological type, and no ulcer scar could be seen in tumor lesion. However, the tumor was massively invading to the mucosal membrane, with positive lymph vessel invasion, and was of mixed histological type. This was a rare case of small early mucosal cancer 1.0 cm in diameter with lymph node metastasis.
我们遇到了一例伴有淋巴结转移的早期小黏膜型胃癌病例。患者为一名75岁女性，被诊断为胃窦大弯侧0 IIa型早期胃癌。我们实施了远端胃切除术，并采用毕罗Ⅰ式重建。肿瘤病变位于胃窦大弯侧。组织学检查发现第4d组淋巴结有转移。肿瘤为局限于黏膜的0 IIa型，直径1.0 cm，组织学类型为分化型，肿瘤病变处未见溃疡瘢痕。然而，肿瘤大量侵犯黏膜层，伴有淋巴管侵犯阳性，且为混合型组织学类型。这是一例罕见的直径1.0 cm的伴有淋巴结转移的早期小黏膜癌病例。
