Early Gastric Cancer Showing Gastric Mucin Phenotype without Helicobacter pylori Infection, in a Patient with FAP, Report of a Case Yoshifumi Takahashi 1 , Manabu Takeuchi 1 , Gen Watanabe 2 , Masaaki Kobayashi 3 , Yuichi Sato 1 , Yoichi Ajioka 2 , Yutaka Aoyagi 1 1Department of Gastroenterology, Niigata University Medical and Dental Hospital, Niigata, Japan 2Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan 3Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan Keyword: FAP , H. pylori陰性 , 早期胃癌 , 幽門腺型腺腫 , 胃底腺ポリープ pp.915-920
Published Date 2014/5/25
DOI https://doi.org/10.11477/mf.1403114182
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 The patient was a male in his twenties with FAP(familial adenomatous polyposis). Conventional endoscopy revealed fundic gland polyposis spreading over the stomach, except in the antrum, and a white, slightly elevated lesion, approximately 10mm in diameter on the anterior wall of gastric fornix. The background mucosa showed regular arrangement of collecting venules and no atrophy, and stool H. pylori antigen was negative. The surface of the lesion revealed rough and granular patterns of various shapes. Magnifying endoscopy with NBI(narrow band imaging)showed irregular granular/papillary surface structures with loop-shaped microvascular vessels. Though the histopathogical diagnosis of the biopsy specimen was Group 3(tubular adenoma, low-grade atypia), NBI findings were considered to be intramural, well-differentiated, early gastric carcinoma. After obtaining informed consent from the patient, ESD(endoscopic submucosal dissection)was performed. Histologically, the resected specimen was diagnosed as a well-differentiated adenocarcinoma with low grade atypia, which showed a gastric mucin phenotype.

 For patients with FAP without H. pylori infection, it is important to investigate the stomach using endoscopy, particularly the gastric body to detect early cancer, as reported in this case.

Copyright © 2014, Igaku-Shoin Ltd. All rights reserved.


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