EndoTODAY 내시경 교실
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[Gastric cancer 480 - Remnant gastric cancer]
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제가 가장 무서워하는 암은 보만 4형 진행성 위암입니다. 그 다음이 잔위암입니다. 이 둘의 합은 정말 무섭습니다. 잔위에서 발생한 보만 4형 진행성 위암은 정말로 무섭습니다.
이분은 잔위암입니다. 마치 화생성위염처럼 보여서 조직검사를 했다는 것이 우연 같기도 합니다만... 여하튼 아래와 같은 결과였습니다.
내시경 결과
STOMACH : S/P Subtotal Gastrectomy with B-II. Both afferent and efferent loops were clean and patent. There was no evidence of tumor recurrence. Diffuse hyperemic mucosal change with mucosal nodualarities were -noticed on the remnant stomach (#2 x1: G/C side of remnant stomach - hyperemia, #3 x1: L/C side of remnant stomach - mucosal nodularity)
IMPRESSION : S/P Subtotal Gastrectomy with B-II, No Evidence of Tumor Recurrence, Metaplastic gastritis
조직검사 결과
3. Stomach, "lesser curvature, remnant stomach", biopsy: TUBULAR ADENOCARCINOMA, POORLY DIFFERENTIATED
수술 결과
Stomach, total gastrectomy:
Early gastric carcinoma
1. Location : center at anastomosis site and lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : signet-ring cell carcinoma
4. Histologic type by Lauren : diffuse
5. Size : 2.6x1.8x0.2 cm
6. Depth of invasion : extension to mucosa (muscularis mucosa) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal, 4.6 cm; distal, 4.3 cm
8. Lymph node metastasis : no metastasis in 2 regional lymph nodes (pN0) (0/2: "1", 0/2; "2", 0/0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
* 참고: EndoTODAY 잔위암
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.
