GASTRIC ADENOCARCINOMA OF THE FUNDIC GLAND TYPE OCCURRING IN MUCOSA THAT WAS NOT INFECTED WITH HELICOBACTER PYLORI : REPORT OF A CASE

Abstract

A 47-year-old man underwent esophagogastroduodenoscopy and it showed a slightly white depressed lesion at the greater curvature of the mid-gastric body. On magnifying endoscopy with narrow band imaging, the tumor surface presented a relatively uniform papillary and granular structure although the microstructures differed in size, and the microvessels in the part between the fossa presented a relatively uniform loop pattern. The background gastric mucosa did not have atrophy. The ratio of serum pepsinogen I and II also suggested a nonatrophic gastric mucosa and he was not infected with Helicobacter pylori. We made the diagnosis of well differentiated adenocarcinoma infiltrating the submucosal layer on the basis of a biopsy specimen from the lesion, and performed distal gastrectomy. The pathological examination showed well differentiated adenocarcinoma with minimal cytologic atypia. Mucin histochemistry showed a gastric phenotype and positivity for pepsinogen - I. Therefore, we diagnosed him as having gastric adenocarcinoma of the fundic gland type.