Strip biopsy法で切除したラズベリー様腺窩上皮型胃癌の1例

A case of raspberry-like foveolar-type gastric adenocarcinoma resected by strip biopsy

Creators Fujimura Hiroyuki

Creators Nishikawa Jun

Creators Hamabe Koichi

Creators Izumiya Yuta

Creators Matsumoto Satoko

Creators Yoshitomi Shingo

Creators Ito Shunsuke

Creators Yamaoka Yuko

Creators Shirasawa Tomohiro

Creators Goto Atsushi

Creators Hashimoto Shinichi

Creators Okamoto Takeshi

Creators Hoshii Yoshinobu

Creators Sakaida Isao

症例は38歳,男性.近医で施行された上部消化管内視鏡検査で,胃穹窿部に隆起性病変を認めた.生検でGroup4であったため,精査加療目的に当院を紹介受診した.当院での上部消化管内視鏡検査では胃穹窿部にラズベリー様の5mm大の発赤調,亜有茎性の隆起性病変を認めた.背景粘膜に萎縮性胃炎は認めず,Helicobacter pyloriは陰性であった.Strip biopsy法により内視鏡的に切除を行い,病理組織学的には腺窩上皮型胃癌であった.本邦報告例では,ラズベリー様腺窩上皮型胃癌は,数mm大の粘膜内癌で,一般的にESDの治療難易度が高いとされるU,M領域の大彎や胃穹窿部に発見されており,簡便に短時間で治療が可能であるStrip biopsy法の良い適応と考える.今回,Strip biopsy法で切除したラズベリー様腺窩上皮型胃癌の1例を経験したので,文献的考察を加え報告する.

A 38-year-old man was referred to our hospital for detailed examination of a gastric polyp which was suspected to be early gastric cancer. Esophagogastroduodenoscopy revealed a semipedunculated polyp in the fornix. The shape of the polyp was like a raspberry. There was no atrophy of the gastric mucosa, and anti-Helicobacter pylori antibody was negative. Strip biopsy was performed, pathological examination showed that the lesion was a foveolar-type gastric adenocarcinoma. Complete en bloc resection was achieved, in accordance with the current Japanese guidelines. Raspberry-like foveolar-type gastric adenocarcinomas have been found as intramucosal carcinoma of a few millimeters in size and is a good indication for strip biopsy. We reported a case of foveolar-type gastric adenocarcinoma resected by strip biopsy with a review of the literature.

[ISSN]0513-1731

[NCID]AN00243156