Japanese

Two Cases of Adenocarcinoma Occurring in Sporadic Fundic Gland Polyps Observed by Magnifying Endoscopy with Narrow Band Imaging Tetsuya Ueo 1 , Kazumi Togo 1 , Hideho Honda 1 , Hirotoshi Yonemasu 2 , Shotaro Inoue 1 , Yuji Abe 1 , Kurato Wada 1 , Hiroshi Tanabe 3 , Kenshi Yao 4 , Akinori Iwashita 3 , Kazunari Murakami 5 1Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan 2Department of Pathology, Oita Red Cross Hospital, Oita, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan 4Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 5Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan Keyword: 胃底腺ポリープ , 散発性 , 超高分化腺癌 , NBI pp.1529-1535
Published Date 2018/10/25
DOI https://doi.org/10.11477/mf.1403201504
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 The patients were a 60s man and a 60s woman. Upper endoscopic examination of both the patients revealed a small, reddish polypoid lesion, adjacent to an isochromatic small polyp, believed to be a FGP(fundic gland polyp)on the anterior wall of the upper gastric body. Additionally, several FGPs were observed in the non-atrophic background mucosa. Helicobacter pylori was not found in both cases. The findings of ME-NBI(magnifying endoscopy with narrow band imaging)for the reddish polypoid lesion demonstrated an irregular MV(microvascular)architecture composed of either closed loop- or open loop-type vascular components, plus an irregular MS(microsurface structure)consisting of oval-type surface components(vessels within epithelium pattern). In contrast, ME-NBI of the adjacent isochromatic polyp showed regularly arranged round gastric pits and honeycomb-like microvessels(epithelium within vessels pattern). The reddish polypoid lesion was suspected to be an intramucosal adenocarcinoma of differentiated type, whereas the adjacent isochromatic polyp was a non-dysplastic FGP. We resected these two polypoid lesions by ESD(endoscopic submucosal dissection)and pathology revealed the final diagnosis of the reddish polypoid lesion as a well-differentiated adenocarcinoma occurring in FGP, whereas the adjacent isochromatic polyp was a non-dysplastic FGP. Neither of the patients had a history of using proton pump inhibitors and both denied familial adenomatous polyposis. We report two cases of adenocarcinoma occurring in sporadic FGPs, whose ME-NBI findings were useful for differentiating FGP with cancer from non-dysplastic FGP.


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