Case 1, Borrmann's type 2 carcinoma detected by endoscopy in the body of the stomach of a 59-year-old man. Total
gastrectomy with splenectomy was performed. Histologic examination revealed a poorly differentiated carcinoma with marked
venous invasion. Follow-up ultrasonography showed the tumor thrombi in the splenic vein to be progressively distended to the
superior mesenteric vein and the peripheral branches of the intrahepatic portal vein.
Case 2, Borrmann's type 4 carcinoma clinically diagnosed in a 77-year-old man. Ultrasonography detected tumor thrombi in
the left gastric, splenic, and extrahepatic portal veins associated with cavernous transformation at the porta hepatis.
Case 3, Moderately differentiated carcinoma extending from the cardia to the middle body of the stomach diagnosed in a 69-year-old man. Ultrasonography detected a solid mass at the splenomesenteric confluence. Values of α-fetoprotein (AFP) and
protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) were markedly elevated.
Recent progress in imaging technology will increase the probability of encountering the condition reported here. Color
Doppler ultrasonography is useful for diagnosing portal thrombus and provides a great deal of information noninvasively.