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Small Early Gastric Carcinoma with Familiar Adenomatous Polyposis in a Young Patient Diagnosed Accurately by Magnifying NBI, Report of a Case Manabu Takeuchi 1 , Masaaki Kobayashi 2 , Gen Watanabe 3 , Satoru Hashimoto 1 , Yuichi Sato 1 , Rintaro Narisawa 2 , Yoichi Ajioka 3 , Yutaka Aoyagi 1 1Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan 2Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan 3Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan Keyword: NBI , FAP , 胃癌 , ESD , 若年者 pp.263-269
Published Date 2012/2/25
DOI https://doi.org/10.11477/mf.1403113104
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 A male in his twenties with FAP after total colectomy under went conventional endoscopy during surveillance for malignancy. Endoscopy showed two elevated lesions with slightly reddish depressions located in the prepylorus. The biopsy specimens of the larger lesion(A)revealed well-differentiated adenocarcinoma, therefore ESD was recommended. On the day of ESD, conventional endoscopy could not lead to accurate diagnosis for the smaller lesion(B). But magnifying endoscopy with NBI made it possible to diagnose accurately well-differentiated adenocarcinoma. Magnifying NBI revealed irregular microsurface pattern(papillary/tubular surface pattern in various shapes and sizes)and irregular microvascular pattern with a clear demarcation line corresponding to a slightly depressed area. We performed ESD for both lesions in en-bloc fashion without biopsy examination of this lesion. Histopathologically, both of the tumors were diagnosed as adenocarcinoma(tub1, low), pM, ly0, v0, pHM0, pVM0, 0IIc, with tumor size being 4mm and 1mm respectively. For a tiny gastric carcinoma as in this case that may disappear because of the effect of biopsy, magnifying NBI endoscopy is very useful to make an accurate diagnosis.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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