Yoshikawa Takahisa, Murai Shinji, Nakadai Junpei, Oto Ippei, Kitasato Kenjiro, Shimizu Hirotomo, Yabe Nobushige, Kitagawa Yuko
Dept. of Surgery, Keio University School of Medicine.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2414-6.
A 79-year-old woman was admitted with cholangitis caused by a common bile duct stone (CBDS), and the CBDS was removed by endoscopic sphincterotomy (EST). The patient had undergone distal gastrectomy for gastric cancer located in the lower body of the stomach in 2006. A flat, elevated lesion of the cardiac region was noted in the preoperative examination; however, this lesion was not treated because there was no clear evidence of malignancy upon histopathological examination of the biopsy specimen. Following esophagogastroduodenoscopy in 2013, the macroscopic findings had changed to infiltrative cancer. The lesion was considered to be a submucosal(sm)cancer, and the patient underwent simultaneous cholecystectomy and remnant gastrectomy. The histopathological examination of the surgical specimens revealed a well differentiated tubular adenocarcinoma, type 0-IIb+0-IIa, tub1>tub2, pT1b1, ly0, v0, n0.
一名79岁女性因胆总管结石(CBDS)引发胆管炎入院,通过内镜括约肌切开术(EST)取出了CBDS。该患者于2006年因胃体部胃癌接受了远端胃切除术。术前检查发现贲门区有一个扁平隆起病变;然而,由于活检标本的组织病理学检查未发现明确的恶性证据,该病变未得到治疗。2013年进行食管胃十二指肠镜检查后,宏观检查结果已转变为浸润性癌。该病变被认为是黏膜下(sm)癌,患者接受了同期胆囊切除术和残胃切除术。手术标本的组织病理学检查显示为高分化管状腺癌,0-IIb+0-IIa型,tub1>tub2,pT1b1,ly0,v0,n0。