Abstract
Gastritis cystica profunda (GCP) is characterized as a gastric pseudotumor in which the cystic glands penetrate into the submucosal layer. GCP is occasionally accompanied by gastric cancer in the previously operated stomach. However, reports in non-operated stomachs are rare. We report 2 cases of GCP with early gastric cancer in non-operated stomachs. One patient was a 77-year-old male who complained of weight loss, and the other patient was a 75-year-old male who had an abnormal barium study. They had no history of gastric surgery. In both cases endoscopy showed a flat elevated lesion. Endoscopic submucosal dissection (ESD) was performed. On histology, in both patients, cancer cells were located in the mucosal layer and cystic gastric glands without dysplastic epithelial cells in the submucosal layer. The patients were diagnosed as having early gastric cancer with GCP ; in both patients the cancer cell Ki-67 and p53 labeling indices were high. However, in one patient, the labeling indices in the GCP were low, while in other patient they were high. On endoscopic ultrasonography (EUS), low echoic lesions were noted in the submucosal layer in both patients. EUS before ESD is useful for diagnosing of GCP. Further research is required to identify the optimal treatment for early gastric cancer with GCP.
