Helicobacter pylori-Negative Extremely Minute Early Gastric Cancer of Undifferentiated Type, Report of a Case Motochika Yasaka 1 , Kenshi Yao 2 , Takashi Nagahama 1 , Kensei Ohtsu 1 , Yasuhiro Takaki 1 , Toshiyuki Matsui 1 , Hiroshi Tanabe 3 , Kentaro Imamura 3 , Akinori Iwashita 3 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 早期胃癌 , Helicobacter pylori陰性胃癌 , 超微小胃癌 , 未分化型癌 pp.926-930
Published Date 2014/5/25
DOI https://doi.org/10.11477/mf.1403114184
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 A 60-year-old man with epigastric pain was referred to the Department of Gastroenterology, Chikushi Hospital, Fukuoka University, Chikusino. A screening upper endoscopy revealed regular arrangement of collecting venules from the gastric body to the gastric angle ; this tissue was identified as background mucosa without Helicobacter pylori(H. pylori)infection. An isolated, discolored region 2mm in diameter was seen at the greater curvature of the gastric angle within the fundic gland region, which also did not show significant atrophy. The histopathological diagnosis based on the biopsy sample was group V, signet-ring cell carcinoma. ESD(endoscopic submucosal dissection)was performed to resect the lesion, including the biopsy scar, en bloc ; however, no lesions were observed in the resection sample following ESD, and the lesion had disappeared on biopsy. This patient had no history of H. pylori eradication and was negative for H. pylori infection ; in addition, he did not have endoscopic atrophy and histological gastritis. He was thus diagnosed with H. pylori-negative gastric cancer. In the initial routine inspection, a discolored region of the localized(M area in particular)fundic gland region showing little atrophy was a key finding for the early detection of H. pylori-negative signet-ring cell carcinoma.

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