Ochiai Tomoko, Dohi Osamu, Morinaga Yukiko, Seya Mayuko, Fukui Hayato, Iwai Naoto, Konishi Hideyuki, Kishimoto Mitsuo, Konishi Eiichi, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.
Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2024;121(8):689-694. doi: 10.11405/nisshoshi.121.689.
After endoscopic treatment for esophageal cancer, a 65-year-old male underwent surveillance esophagogastroduodenoscopy. A 12-mm discolored flat lesion was noted on the greater curvature of the middle gastric body. Magnifying endoscopy with blue laser imaging demonstrated an irregular papillary surface. Biopsy revealed atypical cells with mucus and irregularly distributed nuclei. The lesion was diagnosed as a gastric-type neoplasm with low atypia. Thereafter, endoscopic submucosal dissection (ESD) was conducted and specimen was sent for biopsy. The ESD specimen suggested a signet-ring cell carcinoma with MUC5AC-positive phenotype and adenocarcinoma of the fundic gland type, with MUC6 positivity and pepsinogen I positivity in the shallow and deeper layers, respectively. Moreover, the cervical region of fundic glands demonstrated a transformation zone of the signet-ring cell carcinoma into an adenocarcinoma of the fundic gland type. Herein, we report this rare case along with a literature review.
一名65岁男性在接受食管癌内镜治疗后,接受了食管胃十二指肠镜监测。在胃体中部大弯处发现一个12毫米的变色扁平病变。蓝光成像放大内镜显示表面呈不规则乳头状。活检发现非典型细胞,有黏液且细胞核分布不规则。该病变被诊断为低异型性胃型肿瘤。此后,进行了内镜黏膜下剥离术(ESD),并将标本送检活检。ESD标本提示为印戒细胞癌,具有MUC5AC阳性表型,以及胃底腺型腺癌,浅层和深层分别为MUC6阳性和胃蛋白酶原I阳性。此外,胃底腺的颈部区域显示印戒细胞癌向胃底腺型腺癌的转化区。在此,我们报告这一罕见病例并进行文献复习。