Abstract
A 50-year-old man underwent endoscopic examination for a medical follow up after endoscopic treatment of common bile duct stones. Esophagogastroduodenoscopy showed a depressive lesion with a fine granular surface and fold convergence at the great curvature of the gastric body. The findings of magnifying endoscopy with narrow band imaging showed irregular microvascular and a microsurface pattern with a demarcation line. Endoscopic submucosal dissection (ESD) was performed. The pathological examination revealed a very well differentiated adenocarcinoma invading submucosal layer accompanied by cystic changes and fibrosis. Mucinhistochemistry showed a gastric phenotype and was positive for Pepsinogen-Icharacteristic for chief cells. We diagnosed the tumor as a M/Gre, 40×42 mm, Type 0-IIa+IIc, very well differentiated adenocarcinoma, pSM2, ly0·v0, pHM0, pVM0, pN0, fundic gland type (chief cell predominant type).
