Fourth Department of Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
Surg Today. 2011 Aug;41(8):1106-11. doi: 10.1007/s00595-010-4420-z. Epub 2011 Jul 20.
We report a case of multifocal gastric cancer with a variety of macroscopic and histological findings. A 65-year-old woman was admitted with upper abdominal pain. Her familial history was remarkable in that her mother had died of gastric cancer. The hematological and blood biochemical values were normal, but the serum was positive for Helicobacter pylori immunoglobulin G, and the serum pepsinogen test was also positive. Gastrointestinal fiberscopy showed many granulomatous lesions coexisting with pedunculated polypoid lesions and marked atrophic gastritis throughout the stomach. We performed total gastrectomy with regional lymph node dissection. There were four separate cancers and three hyperplastic polyps with entire intestinal metaplasia. The pathological findings of these multifocal gastric cancers varied, with coexisting differentiated and undifferentiated types, and early and advanced types. One of the pedunculated polypoid lesions was accompanied by papillary adenocarcinoma. Although multifocal gastric cancer is not uncommon, the present case is considered an extremely unusual example of gastric cancer.
我们报告了一例具有多种宏观和组织学表现的多灶性胃癌。一名 65 岁女性因上腹痛入院。她的家族史值得注意，因为她的母亲死于胃癌。血液学和血液生化学值正常，但血清抗幽门螺杆菌 IgG 呈阳性，血清胃蛋白酶原试验也呈阳性。胃肠纤维镜显示许多肉芽肿性病变共存，伴有带蒂息肉样病变和整个胃明显萎缩性胃炎。我们进行了全胃切除术和区域淋巴结清扫。有四个独立的癌症和三个伴有完全肠上皮化生的增生性息肉。这些多灶性胃癌的病理表现不同，共存分化型和未分化型，以及早期和晚期型。一个带蒂的息肉样病变伴有乳头状腺癌。虽然多灶性胃癌并不罕见，但本例被认为是胃癌的一个极其罕见的例子。
