Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan.
Dig Endosc. 2011 May;23 Suppl 1:92-4. doi: 10.1111/j.1443-1661.2011.01134.x.
We herein report a case of early gastric cancer with mixed components having different grades of atypia, which was correctly predicted by magnifying endoscopy combined with narrow band imaging. A 67-year-old man had a flat elevated lesion (0-IIa) in the anterior wall of the gastric antrum. With narrow band imaging, a flat lateral extension (0-IIb), not recognized with white light imaging was seen in the anal side of the main tumor. Magnifying endoscopy combined with narrow band imaging saw a relatively regular fine network pattern of micro-vessels in the surface of the 0-IIa area. However, in the surface of the 0-IIb area, a villous structure with villi of various size and heterogeneity, micro-vessels showing tortuousity were observed. We judged the grade of atypia to be higher in the 0-IIb area than in the 0-IIa area. Histological examination of the resected specimen verified the 0-IIa area and 0-IIb area as adenoma and adenocarcinoma, respectively.
我们在此报告一例混合成分的早期胃癌，其异型程度不同，通过放大内镜结合窄带成像可准确预测。一名 67 岁男性在前壁胃窦部有一平坦隆起性病变（0-IIa）。在窄带成像下，主肿瘤的肛侧可见到与白光成像不匹配的平坦侧向延伸（0-IIb）。放大内镜结合窄带成像观察到 0-IIa 区域表面相对规则的微血管精细网络模式。然而，在 0-IIb 区域的表面，观察到有各种大小和异质性的绒毛结构，微血管显示迂曲。我们判断 0-IIb 区域的异型程度高于 0-IIa 区域。切除标本的组织学检查证实 0-IIa 区和 0-IIb 区分别为腺瘤和腺癌。
