Differential diagnosis of stomach cancer

I. Cancer, or ulcers? This issue always occurs when stomach occurs more or less extensive, often single ulceration, and solved sometimes with great difficulty. Known to some macroscopic signs to suspect malignant ulcer. These signs include:
a) the rough edges of the ulcer with paritolu one and the rise and "creeping" other side;
b) irregular shape (like amoeba);
C) the granularity of the mucous around the ulcer, thickening of the mucous membrane;
g) the edges of the ulcer sometimes bright red, I mean, juicy granulation;
d) mucous around the cancerous ulcers weak and pale, flabby, bleeding;
e) the seabed is relatively flat, shallow, gray, granular;
W) ulceration of the edges of ulcers;
C) the basis of malignant ulceration rigid, and folds of mucous converge to one edge.
The final character of ulcers diagnosed using sighting gastrobiopsy, and pieces of cloth should be taken and of the region such ulcers, and from the bottom. Than bigger biopsy, the higher the accuracy of diagnosis. If negative histological examination the final diagnosis should be confirmed only on the operation.
II. Cancer or polyps? Diagnosis of stomach polyps endoscopic method certainly is not difficult, and if you compare endoscopic and x-ray methods, the first preference should be given. According to E. Cent. of the Lutsevich et al. (1977) stomach polyps detected endoscopic technique, more than 50% of cases are not detectable by x-ray.
Fibrogastroscopy allows you to diagnose even very small polyps that were not visible, as a rule, on radiographs. Also, the color of the polyp and changes in the mucous membrane upper allow with a high degree of probability to suspect cancer.
Polypous cancer has significant size (not less than 2 cm)wide basis, breaking into the mucous. On top of this "polyp" can be erosion, hemorrhage, edema, necrosis, i.e., the signs of its destruction. Small polyps, narrow base, juiciness is not broken mucous usually said about adenomatous the polyp.
III. Cancer or benign tumor? To differentiate cancer from benign tumors have rarely and diagnosis this is not difficult. The main features of benign tumors is intact mucosa, peristalsis saved, folding expressed, color mucous not altered or, on the contrary, sharply differs (for instance, yellow when xanthoma).
Diagnosis of gastric stump, as a rule, not be difficult, since the patient is usually falls to the endoscopist if clinical symptoms, and consequently, when appropriate morphological picture. The research itself gastric stump to produce more difficult than the study prasetyawan stomach, as a space for research and orientation of the head of the device is much smaller.
In the cult of the stomach are more likely to experience endophytic cancers. As a rule, the tumor originates or "ends with" on-line gastrojejunostomy, has a characteristic appearance: with multiple sites destroyed mucosa, whitish in color, with necrosis and hemorrhages. Total lesion of the gastric stump is not diagnostic difficulties. Mucous lifeless, dull, grey color, with multiple hemorrhages and granular-papillomatosis" growths. Folding is not. Exophytic and mixed cancers gastric stump practically do not differ from those in neoperabelnom the stomach.
According to our observations, that cancer gastric stump, endoscopic diagnostics which is no problem, as a rule inoperability. Similar data lead and other authors ['t Touch E. A. and others, 1977].