위암. EndoTODAY 이준행

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A patient (F/44) visited my out-patient clinic due to cancer lesion detected in the screening endoscopy 1 day ago.

The endoscopic image was typical of an EGC with undifferentiated type histology. The lesion is pale and slightly depressed with a faint converging fold. The edge was spiculated. The base was relatively flat, but there were some hyperemic areas. Based on these findings, I recommended surgery. EGD, CT, and basic pre-op laboratory tests were prescribed.

In the surgical pathology, the depth of invasion was SM3, and there was a lymph node metastasis at #3 station (lesser curvature).

Stomach, subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at body and anterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated
4. Histologic type by Lauren : mixed
5. Size : 2.1x1.8 cm
6. Depth of invasion : invades submucosa (sm3) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 2.1 cm, distal 9.5 cm
8. Lymph node metastasis : metastasis to 1 out of 33 regional lymph nodes (pN1), (perinodal extension: present) (1/33: "3", 1/6; "4", 0/8; "5", 0/6; "6", 0/1; "7", 0/1; "9", 0/2; "8a", 0/2; "11p", 0/1; "12a", 0/3; "4sb", 0/0; "1", 0/3)
9. Lymphatic invasion : present
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1b N1