Gastric Lesions of the Satoyoshi Syndrome Takashi Nagahama 1 , Hiroshi Tanabe 2 , Kenshi Yao 1 , Yasuhiro Takaki 1 , Fumihito Hirai 1 , Takashi Hisabe 1 , Toshiyuki Matsui 1 , Akinori Iwashita 2 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 里吉症候群 , 里吉病 , 消化管病変 , スキルス胃癌 , gastroenterocolitis cystica polyposa pp.528-534
Published Date 2010/4/25
DOI https://doi.org/10.11477/mf.1403101894
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 Satoyoshi syndrome is characterized by 3 principal manifestations, namely, progressive muscle spasms(muscle cramps), generalized alopecia and diarrhea, and, rarely, gastrointestinal lesions attributable to GCP(gastroenterocolitis cystica polyposa). In some of these cases diffuse fibrous thickening develops in the gastric wall, and some of the patients exhibit evidence of widespread poor distensibility of the gastric wall and leather-bottle-like deformation resembling scirrhous gastric carcinoma. Findings that enable differential diagnosis from typical scirrhous gastric carcinoma are : (1) little irregular stiffening of the wall margin, and distensibility maintained to a very small extent,(2) the typical morphological findings of Satoyoshi syndrome in addition to the absence of the unique IIc surface of scirrhous carcinoma,(3) the presence of multiple granular protrusions composed of island-like fundus gland remnants due to loss of the mucosal epithelium or severe atrophy, and (4) the presence of cystic dilatation of the glands in the lamina propria mucosae and multiple submucosal protrusions caused by deep cysts in the submucosa. In addition to the findings of GCP, the histopathological findings consist of band-like or laminar fibrous hyperplasia in the superficial layer of the lamina propria mucosae and edema in the deep layer, and these findings may be helpful in making a diagnosis by biopsy. After learning about this pathology, if Satoyoshi syndrome is suspected based on the presence of the characteristic 3 principal manifestations and the preceding duodenal and small bowel lesions, and the above-described findings are detected, it is easy to differentiate Satoyoshi syndrome from scirrhous carcinoma of the stomach.

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