Hwang Eun Jung, Jang Jae Young, Kim Yun Wha, Dong Seok Ho, Kim Hyo Jong, Kim Byung-Ho, Chang Young Woon
Department of Gastroenterology, Kyung Hee University School of Medicine, Seoul, Korea.
Clin Endosc. 2013 Nov;46(6):666-70. doi: 10.5946/ce.2013.46.6.666. Epub 2013 Nov 19.
The incidence of early gastric cancer (EGC) has increased to >50% in Korea owing to a higher detection rate caused by rapid advances in diagnostic instrumentation. EGC with distant metastasis has been rarely reported. Here, we report the case of a 76-year-old woman in whom general EGC was initially diagnosed by endoscopy and endoscopic ultrasonography. She subsequently underwent endoscopic submucosal dissection (ESD). Histological examination of the ESD specimen revealed that neoplastic cells were located predominantly in the submucosal layer and submucosal lymphatic channels. Metastatic cancer cells were also found in the pleural effusion. After conducting all analyses, including immunohistochemical staining, we concluded that the patient had primary EGC with pleural metastasis.
由于诊断仪器的快速发展导致胃癌早期（EGC）的检出率提高，韩国早期胃癌的发病率已增至50%以上。伴有远处转移的早期胃癌鲜有报道。在此，我们报告一例76岁女性患者，其最初通过内镜检查和超声内镜诊断为早期胃癌。随后她接受了内镜下黏膜下剥离术（ESD）。ESD标本的组织学检查显示肿瘤细胞主要位于黏膜下层和黏膜下淋巴通道。胸腔积液中也发现了转移癌细胞。在进行包括免疫组化染色在内的所有分析后，我们得出结论，该患者患有原发性早期胃癌伴胸膜转移。
