[Extension modes in Borrmann-4 stomach carcinoma estimated by macroscopic appearances].

The clinico-pathologic findings on 91 patients with Borrmann-4 gastric carcinoma were studied. Based on macroscopic appearance of the gastric lesions, Borrmann-4 carcinoma was classified into 4 subtypes; (1) giant rugae type, (2) IIc surface type, (3) erosion type and (4) stricture type. According to the clinico-pathological characteristics of each subtype, these main modes of cancerous extension are suggested: Carcinoma of the giant rugae type develops from a small lesion at the gastric body into peritoneal sclerosing infiltration, cancer of the stricture type originates from the gastric antrum and progresses to peritoneal sclerosing infiltration, cancer of the IIc surface type and erosion type develops from large erosive lesions into lymphangitis carcinomatosa.