A Gastric Carcinoma with Lymphoid Stroma Exhibiting Features of a Submucosal Tumor, Report of a Case Takao Kanemitsu 1 , Takashi Nagahama 2 , Shinichiro Maki 2 , Motoshika Yasaka 2 , Kenshi Yao 2 , Yasuhiro Takaki 2 , Youichiro Ono 2 , Toshiyuki Matsui 2 , Keisuke Ikeda 1 , Hiroshi Tanabe 1 , Atsuko Ota 1 , Akinori Iwashita 1 1Department of Pathology, Chikushi Hospital, Fukuoka University, Chikushino, Japan 2Department of Gastroenterology, Chikushi Hospital, Fukuoka University, Chikushino, Japan Keyword: 粘膜下腫瘍様胃癌 , 胃リンパ球浸潤癌 , Epstein-Barr virus関連胃癌 , 早期胃癌 pp.1975-1980
Published Date 2010/11/25
DOI https://doi.org/10.11477/mf.1403102066
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 A 52-year-old male visited our hospital because of an abnormality found during a medical examination. X-ray images showed a 20mm roundish submucosal tumor-like protrusion at the greater curvature of the lower corpus with a deep depression in the center. A shallow irregularly shaped shadow was in the margin of the deep depression, and a SM(submucosal)cancer exhibiting submucosal tumor-like morphology was suspected. However, lateral images showed a slight wall deformation. In addition, on endoscopy, no bad extension was found in the strong wall extension, but the height of the protrusion changed according to the degree of the wall extension and it seemed softer than the normal SM invasive cancer. Endoscopic ultrasonography showed a hypoechoic mass mainly located in the second and third layers. From a biopsy of the margin of the central depression, the patient was diagnosed as having poorly differentiated adenocarcinoma and underwent a distal gastrectomy. The histopathological findings revealed 0-I+IIc type poorly differentiated adenocarcinoma with lymphoid stroma, pT1b2(SM2), ly0, v0, and no lymph node metastasis. EBV(Epstein-Barr virus)was positive, suggesting EBV-related gastric cancer.

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