[Gastric cancer 716 - 보만 4형]
Parasite | Eso | Sto | Cancer | ESD
[Gastric cancer 716 - 보만 4형]
001 | 101 | 201 | 301 | 401 | 501 | 601 | 701 | 801 | 901 | 1000
보만 4형 진행성 위암은 늘 무섭습니다. 복수는 없었으나 림프절 전이는 대단했습니다.
1. Location : lower third, Center at body and greater curvature
2. Gross type : Borrmann type 4
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated
4. Histologic type by Lauren : diffuse
5. Size : 6.5x5 cm
6. Depth of invasion : invades serosa (pT4a)
7. Resection margin: free from carcinoma; safety margin: proximal 5 cm, distal 4 cm
8. Lymph node metastasis : metastasis to 30 out of 42 regional lymph nodes (pN3b) (perinodal extension: present) (30/42: "2", 0/0; "3", 5/7; "4", 6/6; "5", 0/0; "6", 4/4; "7", 2/3; "9", 7/9; "8a", 4/5; "11p", 0/3; "12a", 2/2; "4sb", 0/0; "1", 0/0; "11d", 0/3; "10", 0/0)
9. Lymphatic invasion : present
10. Venous invasion : present(extramural)
11. Perineural invasion : present
12. Peritoneal cytology : atypical cells
13. AJCC stage by 8th edition: pT4a N3b
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Stomach, subtotal gastrectomy: Advanced gastric carcinoma
1. Location : middle third, Center at body and anterior lesser curvature
2. Gross type : Borrmann type 2
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated
4. Histologic type by Lauren : intestinal
5. Size : 3x2.5 cm
6. Depth of invasion : invades muscularis propria (pT2)
7. Resection margin: free from carcinoma, safety margin: proximal 1.5 cm, distal 7.5 cm
8. Lymph node metastasis : metastasis to 2 out of 33 regional lymph nodes (pN1), (perinodal extension: absent) (2/33: "3", 2/5; "4", 0/8; "5", 0/2; "6", 0/3; "7", 0/4; "9", 0/3; "8a", 0/3; "11p", 0/2; "12a", 0/1; "4sb", 0/0; "1", 0/2)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 8th edition: pT2 N1
Gross type을 병리과에서 보만 2형으로 주었습니다. 저는 보만 3형이 적당할 것으로 생각하였습니다. 따지지는 않았습니다. 어짜피 별 상관이 없는 것이므로.
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2019-1-8)