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Gastric Adenocarcinoma of Fundic Grand Type, Report of a Case Ayumi Osako , Shinichi Miyazaki 1 , Terumi Morita 1 , Megumi Joman 1 , Yuzuru Kai 1 , Tetsuo Konishi 2 , Masaharu Mori 3 , Takashi Yao 4 , Hiroyuki Mitomi 5 , Yasuhiro Hidaka 4,6 1Department of Gastroenterology, Tottori Seikyo Hospital, Tottori, Japan 2Department of Radiology, Tottori Seikyo Hospital, Tottori, Japan 3Department of Pathology, Tottori Seikyo Hospital, Tottori, Japan 4Department of Human Patology, Juntendo University Graduate School of Medicine, Tokyo 5Depaerment of Surgical and Molecular Pathology, Dokkyo Medical University School of Medicine, Tochigi, Japan 6Department of Gastroenterology, Juntendo University School of Medicine, Tokyo Keyword: 胃底腺型胃癌 , 主細胞優位型 , pepsinogen I , MUC6 pp.457-465
Published Date 2015/4/25
DOI https://doi.org/10.11477/mf.1403200212
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 Upper endoscopy screening in an asymptomatic 72-year-old man revealed a reddish elevated lesion 2cm in diameter on the anterior wall of the gastric cardia. He was referred to our hospital for further examination and treatment. Narrow band imaging showed no evidence of cancer in the surface structure and vasculature.

 Biopsy specimens from this lesion revealed a well-differentiated adenocarcinoma from the middle layer of the mucosa to submucosa. Histological analysis of the resected specimen revealed highly atypical cells similar to chief cells that formed an irregular gland mainly from the middle layer of the mucosa to submucosa. Immunohistologically, tumor cells were positive for MUC6, pepsinogen I, and partially positive for H+/K+-ATPase. We finally diagnosed this patient with gastric adenocarcinoma of the fundic gland type (chief cell predominant type), with submucosal invasion. The Ki-67 index was as high as 32.8%. The existence of gastric adenocarcinoma of the fundic gland type is controversial ; however, this case appears to confirm it.


Copyright © 2015, 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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