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Langenbecks Arch Surg. 2009 Jul;394(4):655-60. doi: 10.1007/s00423-008-0427-y. Epub 2008 Oct 18.

Microscopic cancer cell spread in gastric cancer: whole-section analysis of mesogastrium.

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  • 1Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.



Cancer cells are often found in adipose connective tissue separate from the primary lesion and outside lymph nodes on routine pathologic examination of resected gastric cancer specimens. To identify the anatomical relationship between such cancer cell spread and lymph nodes, we investigated the microscopic cancer cell spread in the mesogastrium (CSM) by the whole-section analysis of the mesogastrium.


One thousand five hundred fifty-two sections of the mesogastrium obtained from 37 patients with gastric cancer were subjected. CSM is defined as the existence of cancer cell spread in the mesogastrium separate from the primary lesion.


CSM was detected in three (8%) of the 37 patients. CSM was classified into three types. CSM was found in three of the 12 patients with advanced cancer, but not in 25 patients with early cancer.


CSM may occur in the mesogastrium separate from metastatic lymph nodes; therefore, we should pay particular attention to the potential existence of CSM in surgery for gastric cancer.

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