Ishikawa Akira, Nakamura Koki
Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Gastroenterology, Miyoshi Central Hospital, Miyoshi, Japan.
Case Rep Gastroenterol. 2024 Feb 8;18(1):68-73. doi: 10.1159/000535954. eCollection 2024 Jan-Dec.
Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare histological type of gastric adenocarcinoma that occurs in the stomach and is known for its aggressive behavior. GAED is diagnosed histopathologically and is often advanced at the time of diagnosis.
We report the case of a 70-year-old male with a 20-mm superficial depressed lesion on the anterior wall of the antrum. Histological examination of the endoscopic submucosal dissection specimen revealed that the tumor was composed of dilated or slit-like branching tubules; additionally, the tumor cells had clear cytoplasm resembling that of the fetal digestive tract. Immunohistochemically, the tumor cells were positive for Glypican-3 and alpha-fetoprotein. A pathological diagnosis of GAEDs was established. GAED was found in approximately 30% of all the tumor cells and showed lymphatic invasion. The patient has been under recurrence-free follow-up for approximately 1 year after the endoscopic submucosal dissection.
In order to detect a large number of cases, immunostaining should be aggressively performed if morphological findings are suspicious for GAED.
具有成胚细胞分化的胃腺癌（GAED）是一种罕见的胃腺癌组织学类型，发生于胃，以其侵袭性行为而闻名。GAED通过组织病理学诊断，在诊断时通常已处于进展期。
我们报告一例70岁男性，胃窦前壁有一个20毫米的浅表凹陷性病变。内镜下黏膜下剥离标本的组织学检查显示，肿瘤由扩张或裂隙状分支小管组成；此外，肿瘤细胞具有类似于胎儿消化道的透明细胞质。免疫组织化学检查显示，肿瘤细胞Glypican-3和甲胎蛋白呈阳性。确诊为GAED。在所有肿瘤细胞中约30%发现GAED，并显示有淋巴浸润。内镜下黏膜下剥离术后，该患者已接受约1年的无复发生存期随访。
为了发现大量病例，如果形态学表现怀疑为GAED，应积极进行免疫染色。
