Department of Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan.
Eur J Gastroenterol Hepatol. 2012 Jun;24(6):727-30. doi: 10.1097/MEG.0b013e32835272ea.
Eosinophilic gastroenteritis (EG) is an inflammation of the digestive tract that is characterized by eosinophilic infiltration. There are no specific symptoms, and are related to the layer in which eosinophilic infiltration is observed. A 69-year-old Japanese man presented to our hospital with a history of general malaise, diarrhea, and dysgeusia. Esophagogastroduodenoscopy showed reddish elevated lesions that were edematous all over the gastric mucosa. In addition, three tumors were also observed. The biopsies of the reddish elevated mucosa revealed eosinophilic infiltration and tubular adenocarcinoma from the tumors. Colonoscopy showed abnormal reddish elevated mucosa. The biopsies from the reddish elevated mucosa showed eosinophilic infiltration. From the abdominal contrast computed tomography scan, tumor stain was seen in the anterior wall of the gastric body. No ascites, intestinal wall thickening, or lymph node swelling were found. A slight elevation in the serum immunoglobulin E (IgE), 480 IU/ml, was found from the laboratory test results; other laboratory results were within normal limits including the number of peripheral eosinophils. No specific allergen was found from the multiple antigen simultaneous test and from the skin patch test. The parasitic immunodiagnosis was negative. He was diagnosed with EG associated with gastric cancer and underwent total gastrectomy, regional lymph node dissection with reconstruction by a Roux-en-Y method. He was prescribed prednisolone after the operation and showed a good clinical response. There are many case reports on EG, but none of them were associated with cancer. We encountered a case of EG associated with multiple gastric cancer; the patient underwent total gastrectomy.
嗜酸粒细胞性胃肠炎(EG)是一种以嗜酸性粒细胞浸润为特征的消化道炎症。其没有特异性症状,与嗜酸性粒细胞浸润的层次有关。一位 69 岁的日本男性因全身不适、腹泻和味觉障碍到我院就诊。食管胃十二指肠镜检查显示胃黏膜呈弥漫性红色隆起性病变伴水肿。此外,还观察到三个肿瘤。红色隆起性黏膜的活检显示嗜酸性粒细胞浸润和来自肿瘤的管状腺癌。结肠镜检查显示异常红色隆起性黏膜。红色隆起性黏膜的活检显示嗜酸性粒细胞浸润。腹部对比增强计算机断层扫描显示胃体前壁有肿瘤染色。未发现腹水、肠壁增厚或淋巴结肿大。实验室检查结果显示血清免疫球蛋白 E(IgE)略有升高,为 480IU/ml;其他实验室结果在正常范围内,包括外周嗜酸性粒细胞计数。多重抗原同时检测和皮肤斑贴试验均未发现特定过敏原。寄生虫免疫诊断为阴性。他被诊断为 EG 合并胃癌,并接受了全胃切除术、区域淋巴结清扫术和 Roux-en-Y 法重建。术后他服用了泼尼松龙,临床反应良好。EG 有许多病例报告,但没有与癌症相关的报告。我们遇到了一例 EG 合并多例胃癌的病例,患者接受了全胃切除术。