CA: A Cancer Journal for Clinicians, Vol 3, 57-65, Copyright
© 1953 by American Cancer Society
Early Detection of Carcinoma of the Stomach
Ross Golden M.D.1
1 The Department of Radiology of the College of Physicians & Surgeons of Columbia University and the Radiological Service of the Presbyterian Hospital, New York, New York.
The detection of carcinoma of the stomach by roentgen-ray methods, and to a certain extent by gastroscopy, depends upon two basic physical factors: (1) the location of the growth in the stomach, and (2) the gross growth characteristics of the tumor, i.e., the physical manner in which the tumor involves the stomach wall. Stout's classification is based on this second factor and is the foundation for an understanding of the clinical evolution of this disease and of the difficulties encountered in attempting to detect it.
Figure 8. Linitis plastica type of carcinoma of the stomach. Three roentgenograms (A,B,C) are reproduced here to show (1) the remarkable flexibility of the wall manifested by deep peristaltic waves that expelled barium rapidly, and (2) the great thickening of the mucosal folds. Pressure films disclosed the appearance shown in Fig. 7, B. The gastroscopist interpreted the thickened folds of intact mucosa as evidence of gastritis. At operation extensive inoperable carcinoma was found. A biopsy of the wall, which did not go clear through to the mucosa, disclosed carcinoma cells infiltrating through the muscle without destroying it and growing along the subserosa. Very little fibrosis was present. The preservation of the muscle and the absence of fibrous tissue explain the ability of the stomach to produce deep peristalsis.
