Differentiated Type Gastric Adenocarcinoma with No Previous Helicobacter pylori Infection, Report of a Case Takashi Ito 1 , Noriya Uedo 1 , Ryu Ishihara 1 , Hiroyasu Iishi 1 , Yasuhiko Tomita 2 1Departments of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan 2Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Keyword: 早期胃癌 , Helicobacter pylori , 分化型胃癌 , 胃型粘液形質 pp.903-907
Published Date 2014/5/25
DOI https://doi.org/10.11477/mf.1403114179
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 A woman in her sixties had been diagnosed with a differentiated-type early gastric cancer and presented to our hospital. Anti-Helicobacter pylori antibody was negative and the patients had no history of eradication therapy. An esophagogastroduodenoscopy(EGD)revealed a 20mm depressed-type lesion in the anterior wall of the upper stomach. Helicobacter pylori-associated atrophic gastritis was not detected in the surrounding mucosa. Narrow-band imaging with magnification revealed an irregular microvessel pattern, an irregular microsurface pattern, and a demarcation line in the lesion. There was no endoscopic sign of submucosal invasion, no lymph node involvement, and no distant metastases were detected by CT scan, and the clinical stage of the cancer was determined as cT1a, N0, M0(stage IA). The patient underwent ESD. Histological findings of the resected specimen showed that the lesion was surrounded by fundic gland mucosa without any changes suggestive of atrophy or intestinal metaplasia. The tumor was diagnosed as a Type 0-IIc, 18×18mm, intramucosal well-differentiated tubular adenocarcinoma with minimal, poor differentiation, no ulcerative findings, no lymphatic or venous invasion, and negative horizontal and vertical margins. Immunochemical staining showed that the lesion expressed gastric mucin phenotype.

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