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Early Gastric Cancer with Sarcoid-like Reaction in Gastric Mucosa and Regional lymph Node, Report of a Case Shozo Osera 1 , Yasuhiro Oono 1 , Takeshi Kuwata 2,3 , Shinya Yanagi 3 , Hiroyuki Morimoto 1 , Ken Hatogai 1 , Hideaki Miyamoto 1 , Atsushi Yagishita 1 , Yusuke Yoda 1 , Takashi Kojima 1 , Hiroaki Ikematsu 1 , Tomonori Yano 1 , Mituo Satake 4 , Atushi Ochiai 2,3 , Kazuhiro Kaneko 1 1Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan 2Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan 3Department of Clinical Laboratory, National Cancer Center Hospital East, Kashiwa, Japan 4Diagnostic Radiology, National Cancer Center Hospital East, Kashiwa, Japan Keyword: 早期胃癌 , サルコイドーシス , 非乾酪性類上皮細胞肉芽腫 , 領域リンパ節 , サルコイド肉芽腫 pp.1495-1506
Published Date 2013/9/25
DOI https://doi.org/10.11477/mf.1403113950
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 A 54-year-old woman was diagnosed with gastric disease at a nearby hospital and presented to the National Cancer Center Hospital East. Esophagogastroduodenoscopy showed a discoloration, depressive lesion of 40mm in diameter with fold convergence at the greater curvature of the gastric antrum. Moderately differentiated adenocarcinoma with poorly differentiated adenocarcinoma was detected at biopsy specimen and we diagnosed as Type 0-IIc early gastric cancer infiltrating onto SM deep layer. The depressed yellow lesions were detected in the whole stomach, magnifying endoscopy with narrow band imaging revealed dilated and tortuous vessels, while no tumor vessels were found. The formation of granuloma with epithelioid cells was shown in the biopsy specimen. Although the enlargement of the regional lymph nodes was detected in abdominal CT, the findings of clear distant metastasis were absent. After distal gastrostomy and with D2 lymph node dissection were performed, the pathological examination revealed a pType0-IIc, 37×29mm, tub 2>por2>sig, pT1b(SM2 ; 1,500μm), ly1, v0, INFb, int, pPM0, pDM0, pStage IA. No metastatic findings were found in regional lymph nodes, but gastric mucosa and regional lymph node showed a sarcoid granuloma. There are few reports that showed not only regional lymph node, but also a sarcoid granuloma to gastric mucosa and presented with an endoscope image specific in gastric cancer. This is the reason why we report this case with reference to the literature.


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

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