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[Gastric cancer 930. ÀúÀÌÇüµµ À§¾Ï Áß crawling type (WHYX type)]

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À§¾Ï Áß cellular atypia´Â º°·Î ¾ø´Âµ¥ structural atypia¸¦ º¸ÀÌ´Â °æ¿ì 'ÀúÀÌÇüµµ À§¾Ï'À̶ó°í ºÎ¸¨´Ï´Ù. ¿¹¸¦ µé¾î foveolar type, fundic gland type, intestinal type, crawling type (WHYX lesion)µîÀÌ ¿©±â¿¡ ÇØ´çÇÕ´Ï´Ù. ±× Áß crawling type (WHYX lesion)À» ¼Ò°³ÇÕ´Ï´Ù.

ESD¸¦ ÇÏ¿´°í ÃÖÁ¾ º´¸® °á°ú tubular adenocarcinoma, moderately differentiated (WHYX type), 16mm, lamina propria·Î ³ª¿Ô½À´Ï´Ù.

Á¡¸·»óÇÇ ¾Æ·¡ lamina propria Áß°£°ú ÇÏ´Ü¿¡¼­ ºñÁ¤»ó gland µéÀÌ ¿·À¸·Î Âß... ¸¶Ä¡ ¼Õ¿¡ ¼ÕÀ» Àâ°í ÀÖ´Â µí ¿¬°áµÇ¾î ÀÖ°í, glandÀÇ ¸ð¾çÀÌ ¾ËÆĺª WHYX¿Í ºñ½ÁÇÏ´Ù°í ÇÏ¿© ºÙ¿©Áø À̸§ÀÔ´Ï´Ù.

ÀϺ»¿¡¼­´Â '¼Õ ¿¬°á¾Ï' ȤÀº üôîÏÇü ¾Ï(crawling type)À̶ó°í ºÎ¸£´Â ŸÀÔÀÌ´Ù.

[Âü°í] Æ÷º¹Çü»ù¾ÏÁ¾(crawling-type adenocarcinomas)Àº Á¾¾ç¼¼Æ÷ÀÇ ÇÙÀÌ Àúµî±ÞÀÇ ÀÌÇü¼ºÀ» º¸ÀÌ°í ºÒ±ÔÄ¢ÇÏ°Ô ºÐÁö ȤÀº À¶ÇյǴ ±¸Á¶°¡ Á¶Á÷ÇÐÀû Ư¡ÀÎ Á¾¾çÀ¸·Î WHO 5ÆÇ ºÐ·ù¿¡¼­ Á¤½Ä ¾ÆÇüÀ¸·Î ºÐ·ùµÇ¾î ÀÖÁö´Â ¾Ê´Ù. ÀÌ ¾ÏÁ¾Àº ÇÙÀÇ ÀÌÇü¼ºÀÌ ½ÉÇÏÁö ¾Ê°í ³»°­ ȤÀº Æ´»õ ÇüŸ¦ ÀÌ·ç´Â ±¸Á¶Àû Ư¼ºÀ¸·Î ÀÎÇØ ¿¹Àü¿¡´Â °íºÐÈ­ »ù¾ÏÁ¾À¸·Î °£ÁֵǾúÀ¸³ª, Å©±â°¡ Å« Æ÷º¹Çü»ù¾ÏÁ¾Àº ºÐÈ­°¡ Á¡¸·ÇÏÃþ ÀÌ»óÀ¸·Î ħÀ±À» º¸ÀÌ´Â °æ¿ì ÀúÀÀÁý¾ÏÁ¾ ¼ººÐÀÌ µ¿¹ÝµÇ´Â °æ¿ì°¡ ¸¹À¸¸ç, ¸²ÇÁÀý ÀüÀÌ°¡ ÈçÇÏ¿© ´Ù¸¥ ¾ÆÇü¿¡ ºñÇØ ¿¹ÈÄ°¡ ¾È ÁÁÀ» ¼ö ÀÖ´Ù´Â °ÍÀÌ ¹àÇôÁö°í ÀÖ´Ù. (À§¾Ï º´¸® ¼Ò°ßÀÇ ÀÌÇØ ±è¹éÈñ, À̼ºÇÐ. Ç︮ÄÚ¹ÚÅÍÇÐȸÁö Á¾¼³, 2023)


[Cases]

Tubular adenocarcinoma, M/D, WHYX type (SM1 invasion, not seen in this picture)

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±ÙÀ§ ÀüÁ¤ºÎ ´ë¸¸¿¡ ¾à 1.5cmÀÇ pale, flat elevated lesionÀÌ °üÂûµÈ´Ù. Áß¾ÓÀÇ ÀϺδ ¾à°£ °áÀýÇüÀ¸·Î ÁÖº¯º¸´Ù À¶±âµÇ¾î ÀÖ½À´Ï´Ù. (Á¶Á÷°Ë»ç Æǵ¶Àº highly suggestive of tubular adenocarcinoma, well differentiated (WHYX type)¿´½À´Ï´Ù.

ESD º´¸®. EGC IIb, tubular adenocarcinoma, well differentiated (WHYX type)


°æ°è°¡ ¸Å¿ì ºÒºÐ¸íÇÏ¿´½À´Ï´Ù.

ESD º´¸®. Tubular adenocarcinoma, W/D, WHYX type

* Âü°í: "Crawling-type" adenocarcinoma of the stomach: a distinct entity preceding poorly differentiated adenocarcinoma Gastric Cancer 2013

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2023-10-4)