A variety of schemes have been used to describe the gross appearance of gastric carcinomas. These terms can help communicate findings seen during endoscopy or the gross pathology examination.
Classification schemes:
(1) early gastric cancer, from the Japan Gastroenterological Endoscopic Society
(2) advanced gastric cancer, as defined by Borrmann in 1926
Early gastric cancer = carcinoma limited to the mucosa and submucosa without extension into the muscularis propria.
Advanced gastric cancer = carcinoma extending into and through the muscularis propria.
|
Appearance of Early Gastric Carcinoma |
Term |
JGES Type |
|
raised mass projecting into lumen of stomach |
protruding |
Type I |
|
slightly elevated above the surrounding mucosa |
elevated |
Type IIa |
|
flat lesion, relatively flush with the surrounding mucosa |
flat |
Type IIb |
|
slightly depressed mucosal ulceration extending below the surrounding mucosa, reaching the submucosa |
depressed |
Type IIc |
|
mucosal ulceration extending down to the muscularis propria |
excavated |
Type III |
where:
• An early carcinoma with a Type II pattern may show more than one subtype (IIa, IIb and/or IIc).
|
Appearance of Advanced Gastric Carcinoma |
Term |
Borrmann Type |
|
associated with an exophytic mass projecting into the lumen of the stomach, typically without ulceration |
polypoid or fungating or protruding |
Type I |
|
elevated tumor mass with central ulceration and a raised, rolled margin |
excavating |
Type II |
|
ulcerated area tumor or without a raised margin that is slightly above the surrounding mucosa |
ulcerated and infiltrating |
Type III |
|
relatively flat lesion which may be flush with adjacent mucosa; tumor may diffusely infiltrate below intact mucosa; typically associated with linitus plastica |
diffusely infiltrating |
Type IV |
where:
• Distinction between Types II and III may sometimes seem subjective.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
