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[一例腹腔镜全胃切除术治疗胃幼年性息肉病合并同步多发黏膜内癌]

[A Case of Laparoscopic Total Gastrectomy for Juvenile Polyposis of Stomach with Synchronous Multiple Intramucosal Carcinomas].

作者信息

Sakai Jun, Ono Hidetaka, Otsubo Kana, Tsuura Yukio, Imanishi Kota, Takeshita Yusuke, Takenouchi Akira, Shimozawa Motoharu, Kobayashi Kei, Suwa Hirokazu, Minami Yuta, Nojiri Kazunori, Yoshida Kenichi, Masui Hidenobu, Nagahori Kaoru

机构信息

Dept. of Surgery, Yokosuka Kyosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2022 Dec;49(13):1699-1701.

Abstract

The patient was a 57-year-old woman. She was referred to our hospital because severe anemia. Upper gastrointestinal endoscopy revealed polyposis throughout the stomach and lobulated polyps in cardia, greater curve of middle body of the stomach, and angulus. Colonoscopy and small bowel endoscopy showed no obvious abnormal findings. Based on these findings, a laparoscopic total gastrectomy with D1 lymph node dissection was performed for suspected juvenile polyposis of stomach with severe anemia. The gross examination of the resection specimen revealed diffuse polyposis throughout the stomach, and histopathological examination revealed hyperplasia of the orbital epithelium throughout the stomach and lack of edema in lamina propria of mucous and eosinophil leukocytic infiltration, leading to the diagnosis of juvenile polyposis of stomach. Two well differentiated adenocarcinomas were found in 2 locations, which remained within the mucosa. We report a case of laparoscopic total gastrectomy for juvenile polyposis of the stomach with gastric cancer, with some discussion of the literature.

摘要

患者为一名57岁女性。因严重贫血转诊至我院。上消化道内镜检查显示全胃多发息肉,贲门、胃体中部大弯侧及角切迹处有分叶状息肉。结肠镜检查和小肠内镜检查未发现明显异常。基于这些发现,因怀疑胃幼年性息肉病伴严重贫血,行腹腔镜全胃切除术及D1淋巴结清扫术。切除标本的大体检查显示全胃弥漫性息肉病,组织病理学检查显示全胃眼眶上皮增生,黏膜固有层无水肿及嗜酸性粒细胞浸润,从而诊断为胃幼年性息肉病。在两个部位发现了2处高分化腺癌,均局限于黏膜内。我们报告一例腹腔镜全胃切除术治疗胃幼年性息肉病合并胃癌的病例,并对相关文献进行一些讨论。

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