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Marked Morphological Change in a Gastric-type, Low-grade, Well-differentiated Adenocarcinoma of the Stomach in 1 Year, Report of a Case Ryo Kodama 1 , Hiroyasu Ushimaru 1 , Kenji Kawaguchi 2 , Koichiro Ando 1 , Takumi Yanagisawa 1 , Hisanobu Saegusa 1 , Mutsuki Makino 2 1Department of Gastroenterology, JA Nagano Koseiren Minaminagano Medical Center Shinonoi General Hospital, Nagano, Japan 2Department of Pathology, JA Nagano Koseiren Minaminagano Medical Center Shinonoi General Hospital, Nagano, Japan Keyword: 胃癌 , 低異型度 , 胃型形質 , 形態変化 , 進行癌 pp.989-999
Published Date 2021/6/25
DOI https://doi.org/10.11477/mf.1403202495
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 A 70-year-old man underwent endoscopic submucosal dissection for early gastric cancer 10 years ago, following which he received esophagogastroduodenoscopy every year. During follow-up, a flat elevated lesion measuring 10mm in size was detected in the greater curvature at the fornix of the stomach. Biopsy specimens were diagnosed as group 2. After 1 year, the lesion progressed to a hemispherical elevated lesion measuring 20mm in size. Narrow-band imaging with magnification revealed an irregular mucosal surface pattern of villi-like structure. Based on the biopsy specimens, an extremely well-differentiated adenocarcinoma was suspected. We performed endoscopic submucosal dissection. A pathological examination revealed that the superficial layer of the lesion was very mild atypia of foveolar-type adenocarcinoma, and the tumor invaded to the submucosal layer. Furthermore, the tumor cells were positive for MUC5AC and MUC6 ; therefore, we diagnosed the lesion as a gastric-type, low-grade, well-differentiated adenocarcinoma of the stomach. The vertical margin of the resected specimens was positive with the involvement of vessels, and the patient was subsequently subjected to total gastrectomy.


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

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