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病例介绍患者,男性,54岁,因上腹部隐痛不适半年于1991年2月5日就诊,行胃镜检查见:胃窦部后壁距幽门孔1.5处见一直径1.0cm半球形隆起。境界清楚,表面光滑,广基无蒂。活检病理诊断为腺瘤性息肉。同年8月20日复查胃镜仍见胃窦部有一半球形息肉,其部位、大小与前次相仿。另在胃体小弯侧见一1.5cm×1.0cm不规则浅溃疡,覆盖少许血痂,边缘轻微隆起、潮红,活检病理诊断为胃窦部腺瘤性息肉癌变、胃体小弯腺癌。同年9月5日行胃癌根治术。术中见胃窦部一直径1.0cm半球形隆起,质硬;胃体小弯有1.5cm×1.0cm×0.3cm溃疡灶。术后病理诊断:胃窦部腺瘤性息肉癌变,癌细胞浸润粘膜下层;胃体小弯原位癌,Ⅱ_c型。两处癌灶之间粘膜呈慢性炎症表现,未见癌,未见淋巴结转移,术后情况良好。
Case presentation The patient, male, 54 years old, had a discomfort in the upper abdomen for half a year on February 5, 1991. A gastroscopy examination showed that the posterior wall of the gastric antrum had a 1.0-cm hemispherical bulge at a distance of 1.5 from the pyloric hole. The boundary is clear, the surface is smooth, and there is no pedestal. Biopsy pathological diagnosis of adenomatous polyps. On August 20 of the same year, the re-examination of the gastroscope still showed a half spherical polyp in the gastric antrum. Its site and size were similar to those of the previous time. Another side of the small curvature of the body side of a 1.5cm × 1.0cm irregular shallow ulcers, covering a little blood stasis, the edge of a slight uplift, flushing, biopsy pathological diagnosis of gastric antral adenocarcinoma polyposis, gastric small adenocarcinoma. On the 5th of the same year, the radical gastrectomy was performed. During the operation, the diameter of the gastric antrum was a hemispherical uplift with a diameter of 1.0 cm, and it was hard. The gastric ulcer was a 1.5 cm x 1.0 cm x 0.3 cm ulcer. Postoperative pathological diagnosis: Adenomatous polyposis of gastric antrum, cancer cells infiltrating the submucosa; gastric curvature of small in situ carcinoma, type II_c. The mucosa between the two foci showed chronic inflammation, no cancer, no lymph node metastasis, and good postoperative condition.