Intramucosal Gastric Cancer with Fifteen Metastatic Lymph Nodes: Report of a Case
Intramucosal Gastric Cancer with Fifteen Metastatic Lymph Nodes: Report of a Case
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DOI：
10.5754/hge10102
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发表时间：
2012-10-01
影响因子：
--
通讯作者：
Terashima, Masanori
中科院分区：
文献类型：
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作者：
Tanizawa, Yutaka;Bando, Etsuro;Terashima, Masanori
本报告描述非常罕见的粘膜内型胃癌，并转移至15个淋巴结。1例65岁日本男性因上腹痛住进本院。胃镜检查发现胃角小弯附近后壁有一3.5 cm大小的TIC溃烂病变，伴有黏膜肿瘤侵犯。腹部CT既未发现肿大的淋巴结，也未发现远处转移。他接受了保留幽门的胃切除加淋巴清扫术。活检标本的组织学检查显示印戒细胞癌伴有局限于粘膜层的溃疡疤痕。虽然淋巴管侵犯不明显，但23个被取回的结节中有15个确实受累。最终诊断为II期胃癌，根据日本的胃癌分类，命名为T1N2M0。手术后12个月，病人仍然活着，没有复发。
This report describes very rare intramucosal gastric cancer with metastasis to 15 lymph nodes. A 65-year-old Japanese man was admitted to our hospital with epigastralgia. Endoscopic examination revealed a 3.5cm type tic ulcerated lesion on the posterior wall near the lesser curvature of the angle of the stomach with mucosal tumor invasion. Neither enlarged lymph nodes nor distant metastasis was revealed by abdominal computer tomography. He was treated by pylorus-preserving gastrectomy with lymph node dissection. A histological examination of biopsy specimens revealed signet-ring cell carcinoma with ulcer scar that was limited to the mucosal layer. Although lymphatic vessel invasion was not evident, 15 of 23 retrieved nodes were actually involved. The final diagnosis was stage II gastric cancer; designated T1N2M0 according to the Japanese classification of gastric carcinoma. Twelve months after surgery the patient remains alive without recurrence.