抄録
Multiple ulcers of the antrum frequently produce characteristics which may be confused with those of early gastric cancer types IIc, IIa+IIc and ha. Many of these ulcer cases are cured within a short period of time and the differentiation between benign and malignant ulcer generally is not very difficult. In some cases, however, the ulcer scar may become elevated . This findings makes it quite difficult to differentiate from early gastic cancer type ha by a short-term f ollowiup. We had 8 cases elevated type of the gastric ulcer scar which underwent X-ray and endscopic follow-up, biopsy and, in some of the cases, macroscopic examination of the resected stomach. Based on this findings of these studies, we propose to categorize such scar formations as elevated type of the gastric ulcer scar . This type of the gastric ulcer scar morphologically is characterized by the presence of a convergence of mucosal folds, a picture that is often seen with a malignant tumor . In our cases, histopathological findings were those of an ulcer scar type Ul-II maked by the rupture of the muscularis mucosae and fibrosis with the elevated part of the scar consisting of hyperplastic pyloric glands undergoing cystic dilation. The following points give important clues to the diagnosis of the elevated type of the gastric ulcer scar. (i) An elevation of the gastric mucosa with converging mucosal folds is seen on X-ray and gastroscopy. (ii) There is definite evidence that an ulcer was present at the same site previously. (iii) No malignant cells are detected by biopsy of materials taken from the elevated scar and its surrounding tissue. Pathologic conditions that should be considered in making the diagnosis of the condition in question include early gastic cancer of type I and ha, polyps, atypical epithelial lining, and verruciform gastritis.
