EndoTODAY 내시경 교실
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[Gastric cancer 706 - EGC IIa ?]
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조직검사에서 M/D adenocarcinoma였기에 ESD를 시도하였습니다. 외부 사진을 보고 pale flat and slightly elevated lesion으로 판단하였습니다. 그런데 ESD를 하면서 다시 관찰하니 함몰형으로 보였습니다.
Stomach, endoscopic submucosal dissection: Early gastric carcinoma
1. Location : antrum, posterior wall
2. Gross type : EGC type IIc
3. Histologic type : signet ring cell carcinoma >> tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : diffuse
5. Size of carcinoma : (1) longest diameter, 26 mm (2) vertical diameter, 21 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 700 ㎛) (pT1b)
7. Resection margin : free from carcinoma(N) safety margin : distal 5 mm, proximal 6 mm, anterior 4 mm, posterior 16 mm, deep 800 ㎛ (sm only)
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: present
수술을 하였고 local과 lymph node에 tumor는 없었습니다.
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2018-12-24)