Cover Illustration: Case of the Month–an Early Gastric Cancer (0IIc)
A 31-year-old female was referred to our hospital for treatment of gastric cancer. Gastroscopy revealed a superficial depressive lesion, measuring 5 cm × 4 cm, on the lesser curvature of the gastric angulus (Cover Illustration A). On application of indigo carmine dye, the border of the lesion was clearly demonstrated (Cover Illustration B). Inside the lesion, so-called island-like nodules, non-malignant mucosal areas surrounded by cancerous ‘lake’, were recognized. Biopsy specimens taken from the depressive area revealed signetring cell carcinoma. The tumor was diagnosed as an early gastric cancer of type 0IIc, T1. Distal gastrectomy with D2 lymphadenectomy was performed.
The formalin-fixed specimen showed a shallow depressive area with a number of ‘islands’ (Figure C). Histologically, the tumor invasion was limited to the mucosal layer (Figure D). High power view revealed signet-ring cell and poorly differentiated adenocarcinoma in the depressive area but not in the ‘islands’ (Figure E). Lymphatic or venous infiltration were not evident, and all dissected lymph nodes were negative for metastasis (pN0).
(Chika Kusano, Haruhisa Suzuki. Endoscopy Division, National Cancer Center Hospital, Tokyo)
[Table of Contents]