Takahashi Haruhiko, Yao Kenshi, Ueo Tetsuya, Nagahama Takashi, Imamura Kentaro, Chuman Kenta, Tanabe Hiroshi, Iwashita Akinori, Ueki Toshiharu
Department of Gastroenterology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin Chikushino, Fukuoka 818-8052, Japan.
Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, 818-8052, Japan.
Ecancermedicalscience. 2020 Nov 13;14:1143. doi: 10.3332/ecancer.2020.1143. eCollection 2020.
Adenocarcinomas with differentiation towards fundic or pyloric glands are rare histological subtypes. We herein describe two cases of new histological subtypes: mixed fundic and pyloric mucosa-type adenocarcinoma detected in uninfected patients. The first patient was a woman in her 40s. A glossy, reddish, nodular lesion with a flat elevated whitish area was detected at the gastric fundus. When the nodular lesion was visualised with magnifying narrow-band imaging (M-NBI), an absent microvascular pattern plus an irregular microsurface pattern with a demarcation line was observed. The second patient was a woman in her 60s. A glossy, reddish, elevated lesion was detected at the gastric body. M-NBI finding was a regular microvascular pattern plus a regular microsurface pattern with a demarcation line. Histological examination of the resected specimens from both cases showed a very well- to well-differentiated adenocarcinoma which has differentiation towards the mixed fundic and pyloric mucosa. The histological and serological findings of both cases indicated the absence of infection. The present two cases demonstrate further evidence of a new histological subtype of gastric adenocarcinoma: mixed fundic and pyloric mucosa-type adenocarcinoma, which has distinct characteristic endoscopic findings.
向胃底或幽门腺分化的腺癌是罕见的组织学亚型。我们在此描述两例新的组织学亚型：在未感染患者中检测到的胃底和幽门黏膜混合型腺癌。首例患者为一名40多岁的女性。在胃底发现一个有光泽的、红色的、结节状病变，伴有一个扁平隆起的白色区域。当用放大窄带成像（M-NBI）观察结节状病变时，观察到微血管形态缺失，加上有分界线的不规则微表面形态。第二例患者为一名60多岁的女性。在胃体发现一个有光泽的、红色的、隆起的病变。M-NBI表现为规则的微血管形态加上有分界线的规则微表面形态。对两例患者切除标本的组织学检查显示为高分化至中分化腺癌，向胃底和幽门黏膜混合型分化。两例患者的组织学和血清学检查结果均显示无感染。目前这两例病例进一步证明了胃腺癌新组织学亚型的存在：胃底和幽门黏膜混合型腺癌，其具有独特的内镜特征。
