2019 Volume 61 Issue 10 Pages 2353-2359
A 79-year-old woman underwent endoscopic examination in 2008 and esophagogastroduodenoscopy showed a polypoid lesion in the gastric fornix that was similar in appearance to a hyperplastic polyp. Approximately five years later, the polypoid lesion had slightly enlarged and was now partially surrounded by a depressed lesion. Magnifying narrow band imaging indicated irregular microvascular and absent microsurface patterns within a demarcation line. We diagnosed the patient with early gastric adenocarcinoma, type 0-Ⅱa＋Ⅱc. Endoscopic submucosal dissection was performed. Pathological examination of the resected specimen showed a very well-differentiated tubular adenocarcinoma with differentiation towards the pyloric gland phenotype. Immunohistochemical examination showed positivity for MUC6 and lysozyme, but not pepsinogen-Ⅰ. Therefore, the polypoid lesion was diagnosed as an intramucosal gastric adenocarcinoma of the pyloric mucosa type exhibiting a gastric phenotype. This is the first case of a gastric adenocarcinoma of pyloric mucosa type which was intramucosal carcinoma.
