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□ Fig. 122 a-g. Female patient K., age 55. Diagnosis: gastric cancer. a Stomach roentgenogram (double contrast, horizontal position, left lateral projection): the upper part of the stomach is disfigured, the anterior wall is thickened and rigid due to intramural infiltration (black arrow), atypical relief of the cardiac rosette (white arrow), the esophagus patency unimpaired. In order to verify the spread of infiltration onto the esophagus, the patient was examined by computed tomography. b, c Computed tomograms of the stomach (tight filling with E-Z-CAT DRY, supine position, the level of the stomach fundus): walls are thickened due to intramural infiltration. d, e Computed tomograms of the stomach (tight filling with E-Z-CAT DRY, supine position, the level of the cardiac and subcar-diac parts): infiltration spreads to the abdominal segment of

the esophagus (white arrow), the exophytic tumor component is visualized (black arrow). Conclusion: Cancer of upper part of the stomach with invasion of the esophagus, mixed type of growth. f Macrospeci-men of a resected stomach: the exophytic component in the upper part (arrows) with the changed surrounding relief; infiltration spreads to the esophagus. g Fragment of the macro-specimen (strip): stomach wall is thickened due to intramural infiltration component of white color (arrows). Histologically, adenocarcinoma with the signet-ring cell component.

▲ Fig. 122 g.

D Fig. 123 a, b. Patient S., age 38. Diagnosis: gastric cancer. a Stomach roentgenogram (tight filling, vertical position, anterior projection): organic changes are not detected. b Stomach roentgenogram (double contrast, horizontal position, left posterior oblique projection): stomach contour depressed on the anterior wall of upper part of the stomach, the wall at this level is rigid, the folds terminate near the infiltration (arrows). Conclusion: Infiltrative cancer of the anterior wall of the upper part of the stomach. The patient was operated. Histologically, non-differentiated cancer.

D Fig. 124 a-e. Female patient A., age 70. Diagnosis: gastric cancer. a Stomach roentgenogram (tight filling, vertical position, anterior projection): walls of the subcardiac part are thickened due to intramural infiltration (arrows). b Roentgenogram of the stomach and the lower third of the esophagus (tight filling, vertical position, anterior projection) at the moment of contrast medium passage through the gastroesophageal junction: uneven narrowing of the abdominal segment of the esophagus, its contours are uneven (arrow). c, d Stomach roentgenograms (double contrast, horizontal position, left lateral projection): atypical relief of the cardiac rosette (white arrows), anterior wall is thickened due to intramural infiltration (black arrows). e Roentgenogram of the stomach and the lower third of the esophagus (double contrast, horizontal position, left lateral projection) at the moment of contrast medium passage through the gastroesophageal junction: abdominal segment of the esophagus is unevenly narrowed, its contour uneven and eroded (arrow). Conclusion: Infiltrative cancer of the upper part of the stomach with invasion of the esophagus. The patient was operated. Histologically, adenocarcinoma with the signet-ring cell component.

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