小野 倫子, 谷口 信行, 重田 浩一朗, 横田 京子, 中村 みちる, 川井 夫規子, 藤井 康友, 王 怡, 尾本 きよか, 伊東 紘一

Tomoko ONO, Nobuyuki TANIGUCHI, Kouichirou SHIGETA, Kyoko YOKOTA, Michiru NAKAMURA, Fukiko KAWAI, Yasutomo FUJII, Yi WANG, Kiyoka OMOTO, Kouichi ITOH

自治医科大学臨床検査医学

Department of Clinical Laboratory Medicine, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi-machi, Kawachi-gun, Tochigi-ken 329-0498, Japan

キーワード : Color Doppler ultrasonography, Gastric cancer, Portal vein, Tumor thrombus

Case 1, Borrmann's type 2 carcinoma detected by endoscopy in the body of the stomach of a 59-year-old man. Total gastrectomy with splenectomy was performed. Histologic examination revealed a poorly differentiated carcinoma with marked venous invasion. Follow-up ultrasonography showed the tumor thrombi in the splenic vein to be progressively distended to the superior mesenteric vein and the peripheral branches of the intrahepatic portal vein.
Case 2, Borrmann's type 4 carcinoma clinically diagnosed in a 77-year-old man. Ultrasonography detected tumor thrombi in the left gastric, splenic, and extrahepatic portal veins associated with cavernous transformation at the porta hepatis.
Case 3, Moderately differentiated carcinoma extending from the cardia to the middle body of the stomach diagnosed in a 69-year-old man. Ultrasonography detected a solid mass at the splenomesenteric confluence. Values of α-fetoprotein (AFP) and protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) were markedly elevated.
Recent progress in imaging technology will increase the probability of encountering the condition reported here. Color Doppler ultrasonography is useful for diagnosing portal thrombus and provides a great deal of information noninvasively.