Fukui Yasuhiro, Kato Yukihiro, Okazaki Yuki, Kushitani Yukako, Kametani Naoki, Tokumoto Mao, Yoshii Mami, Ako Eiji, Yamada Nobuya, Nishimura Shigehiko, Taenaka Naoyuki
Dept. of Surgery, Sumitomo Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1839-1841.
A 46-year-old man underwent a medical check-up and gastrointestinal endoscopy, which revealed a brown lesion at the greater curvature of the gastric body. Biopsy was performed, and a gastric neuroendocrine tumor(NET)was diagnosed. The serum levels of gastrin and other tumor markers were not elevated. The preoperative diagnosis was Rindi type Ⅲ gastric NET, and laparoscopic distal gastrectomy with D1 plus lymph node dissection was performed. Histological examination showed that the resected specimen was positive for chromogranin A, CD56, and synaptophysin, which was consistent with the findings of NET. Even though the tumor diameter was only 3 mm, a metastatic #4d lymph node was found. This case suggests that Rindi type Ⅲ gastric NET has high malignant potential, and gastrectomy with lymph node dissection is necessary, regardless of tumor size.
一名46岁男性接受了医学检查和胃肠内镜检查,结果显示胃体大弯处有一个褐色病变。进行了活检,诊断为胃神经内分泌肿瘤(NET)。胃泌素和其他肿瘤标志物的血清水平未升高。术前诊断为林迪Ⅲ型胃NET,遂行腹腔镜远端胃切除术加D1淋巴结清扫术。组织学检查显示,切除标本嗜铬粒蛋白A、CD56和突触素呈阳性,这与NET的表现一致。尽管肿瘤直径仅3毫米,但发现了一枚转移的#4d淋巴结。该病例表明,林迪Ⅲ型胃NET具有较高的恶性潜能,无论肿瘤大小,行胃切除术加淋巴结清扫术都是必要的。