Stomach and Intestine(Tokyo) Volume 54, Issue 7 (June 2019)

Autoimmune Gastritis Mimicking Gastric Pseudopolyposis, Report of a Case Toshifumi Ozawa 1 , Yasuharu Kaizaki 2 , Kyosuke Miura 1 , Hirokazu Shirai 1 , Takayuki Nakagawa 1 , Masaya Saito 1 1Department of Gastroenterology, Inuyama Central General Hospital, Inuyama, Japan 2Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan Keyword: A型胃炎 , 偽ポリポーシス , 拡大内視鏡 , IEE , AIG pp.1058-1062
Published Date 2019/6/25
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 A female in her 60s was admitted to our department for further examination of atrophic gastritis. Her antiparietal cell antibody level was 80 times the normal level, and her serum gastrin level was 4,804pg/ml. Her pepsinogen(PG)-I level was 12.9ng/ml, and the PG-I/PG-II ratio was 1.1, suggesting severe atrophy. Gastrography showed numerous polypoid lesions of the gastric body and fornix. Gastroscopy showed severely atrophic mucosa(Kimura-Takemoto Classification:O-3)at the gastric body and fornix, except for the antrum. After spraying indigo carmine dye, we noted numerous flat elevated lesions, which were approximately the same size. NBI-magnifying endoscopy showed round and short-tubular structures on flat elevated lesions. The biopsy specimens of the elevated lesions revealed atrophic proper gastric glands and totally extinguished parietal cells. Endocrine micronest has not been proven despite additional immunostaining. In this patient, pseudopolyposis was caused by hypertrophy of the foveolar epithelium with atrophic proper gastric glands, not NET or collagenous gastritis.

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54巻7号 (2019年6月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院