Namikawa Tsutomu, Marui Akira, Yokota Keiichiro, Yamaguchi Sachi, Fukudome Ian, Uemura Sunao, Munekage Masaya, Maeda Hiromichi, Kitagawa Hiroyuki, Kobayashi Michiya, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kochi, Japan.
Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan.
Cancer Diagn Progn. 2021 Nov 3;1(5):507-512. doi: 10.21873/cdp.10068. eCollection 2021 Nov-Dec.
Anisakiasis-related gastric eosinophilic granuloma is rare.
Herein, we report a patient with anisakiasis-related gastric eosinophilic granuloma who was treated with laparoscopic and endoscopic cooperative surgery (LECS). A 59-year-old woman was presented to our hospital for further examination of a gastric lesion that was initially diagnosed by a local medical doctor. Esophagogastroduodenoscopy showed a submucosal tumor-like lesion in the lower body of the stomach. Endoscopic ultrasonography showed a heterogeneous hypoechoic submucosal mass lesion in the submucosal layer measuring 10 mm, without evidence of deep involvement. Under a clinical diagnosis of gastrointestinal stromal tumor, the patient underwent LECS. Gross appearance of the resected specimen revealed a 1.5×1.0 cm submucosal tumor-like lesion. Microscopic examination revealed necrosed insects consistent with the characteristics of gastric anisakiasis, around which prominent eosinophilic infiltration and granulomas were observed. This prompted a diagnosis of gastric eosinophilic granuloma related to anisakiasis.
To the best of our knowledge, this is the second case of gastric eosinophilic granuloma related to anisakiasis resected by LECS in the English medical literature. LECS might be a useful procedure for minimally invasive therapeutic diagnosis.
与异尖线虫病相关的胃嗜酸性肉芽肿较为罕见。
在此，我们报告一例接受腹腔镜与内镜联合手术（LECS）治疗的与异尖线虫病相关的胃嗜酸性肉芽肿患者。一名59岁女性因当地医生最初诊断的胃部病变来我院进一步检查。食管胃十二指肠镜检查显示胃体下部有一个黏膜下肿瘤样病变。内镜超声检查显示黏膜下层有一个大小为10毫米的不均匀低回声黏膜下肿块病变，无深层浸润迹象。在临床诊断为胃肠道间质瘤后，该患者接受了LECS。切除标本的大体外观显示有一个1.5×1.0厘米的黏膜下肿瘤样病变。显微镜检查发现坏死的虫体符合胃异尖线虫病的特征，其周围可见明显的嗜酸性粒细胞浸润和肉芽肿。这提示诊断为与异尖线虫病相关的胃嗜酸性肉芽肿。
据我们所知，这是英文医学文献中第二例通过LECS切除的与异尖线虫病相关的胃嗜酸性肉芽肿病例。LECS可能是一种用于微创治疗诊断的有用方法。
