Novel Magnified Endoscopic Findings with Narrow-band Imaging Characteristic for Very-Well- Differentiated Gastric Adenocarinoma Kenshi Yao 1 , Hiroshi Tanabe 2 , Takashi Nagahama 3 , Yasuhiro Takaki 3 , Shinichiro Maki 3 , Seiji Haraoka 2 , Akinori Iwashita 2 , Masao Takeichi 4 , Sadamune Hatakeyama 5 , Yasuhiko Uchida 6 , Toshiyuki Matsui 3 1Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 4Kikuchi Clinic, Miyama, Japan 5Hatakeyama Clinic, Fukuoka, Japan 6Uchida Hospital, Kamashi, Japan Keyword: 早期胃癌 , 低異型度癌 , 超高分化腺癌 , 拡大内視鏡 , NBI , 粘液形質 pp.1159-1171
Published Date 2010/6/25
DOI https://doi.org/10.11477/mf.1403101971
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 Aims : We investigated the findings of magnifying endoscopy with narrow-band imaging characteristic for very-well differentiated gastric adenocarcinoma. Methods : We selected 4 cases of very-well differentiated adenocarcinomas from among the cases which were diagnosed in Fukuoka University Chikushi Hospital between January, 2006 and March, 2010. We reviewed all of the endoscopic findings together with histopathological findings obtained by hematoxylin & eosin staining and immunostaining. Results : The magnified endoscopic findings are different depending upon the histological structure and mucin phenotype. Characteristic findings of the histological structure and the magnified endoscopic findings according to each case are as follows : Case 1 with foveolar epithelial type showed irregular villous epithelial structure and irregular microvascular pattern(so called “villous carcinoma". Case 2 with intestinal epithelial type demonstrated distorted epithelial structure with light blue crest and white opaque substance with irregular microvascular pattern. Case 4 with gastric and intestinal phenotype represented a vessel within an epithelial circle(VEC)pattern. Case 4 with gastric and intestinal phenotype showed irregular reticular microvascular pattern with speckled white opaque substance. Conclusion : Each finding seemed to be specific for the respective phenotype of very well differentiated adenocarcinoma. Furthermore, the vessel-surface(VS)classification system was useful for making a correct diagnosis of very-well differentiated adenocarinoma.

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