Konuma Hironori, Konuma Ichiro, Fu Kuangi, Yamada Satoshi, Suzuki Yutaka, Miyazaki Akihisa
Hironori Konuma, Kuangi Fu, Akihisa Miyazaki, Department of Gastroenterology, Juntendo Univerity Nerima Hospital, Nerima, Tokyo 177-8521, Japan.
World J Gastrointest Endosc. 2013 Jun 16;5(6):300-3. doi: 10.4253/wjge.v5.i6.300.
A 28-year-old woman visited our clinic with a chief complaint of epigastralgia. She had received successful Helicobacter pylori (H. pylori) eradication therapy 5 years before. We repeated esophagogastroduodenoscopy, and a discolored depressed area with reddish spots and converging folds, 20 mm in size, was detected. No atrophic change including intestinal metaplasia or nodular gastritis was seen endoscopically. Two endoscopic biopsies revealed undifferentiated adenocarcinoma. No H. pylori was found, and the (13)C-urea breath test was also negative. Abdominal computed tomography demonstrated no nodal involvement, distant metastasis or fluid collection. She underwent a laparoscopy-assisted distal gastrectomy. Histologically, the resected specimen revealed an early undifferentiated gastric cancer that had invaded deeply into the submucosal layer. Nodal involvement was histologically confirmed. No atrophic change or H. pylori infection was evident histologically. This is the youngest patient ever reported to have developed a node-positive early gastric cancer after eradication of H. pylori.
一名28岁女性因上腹痛为主诉前来我院就诊。她5年前曾成功接受过幽门螺杆菌（H. pylori）根除治疗。我们再次进行了食管胃十二指肠镜检查，发现一个大小为20毫米的变色凹陷区域，有红色斑点和汇聚的皱襞。内镜检查未发现包括肠化生或结节性胃炎在内的萎缩性改变。两次内镜活检显示为未分化腺癌。未发现幽门螺杆菌，（13）C -尿素呼气试验也为阴性。腹部计算机断层扫描显示无淋巴结受累、远处转移或积液。她接受了腹腔镜辅助远端胃切除术。组织学检查显示，切除标本为早期未分化胃癌，已深深侵入黏膜下层。组织学证实有淋巴结受累。组织学上未发现萎缩性改变或幽门螺杆菌感染。这是有报道的根除幽门螺杆菌后发生淋巴结阳性早期胃癌的最年轻患者。
