2019 Volume 61 Issue 8 Pages 1547-1553
We present the case of a 70-year-old man who had undergone upper gastrointestinal endoscopy and was found to have a 7 mm, discolored, submucosal tumor-like elevated lesion on the lesser curvature of the upper gastric body ten years ago. Since then, annual follow-up endoscopy showed no change in its size or shape, but 10 years after the initial examination, it had expanded to 9 mm in diameter and formed depressed areas. A biopsy specimen from the depressed lesion was diagnosed as gastric adenocarcinoma of fundic gland type. One month after the biopsy, magnifying endoscopy with narrow band imaging (NBI) detected an irregular microsurface (MS) and microvascular (MV) pattern in this lesion, and endoscopic submucosal dissection (ESD) was performed. Histopathologically, the tumor developed mainly in the deep layer of the lamina propria, appeared on the mucosal surface in depressed areas, and partially infiltrated into the submucosal layer. Few reports have examined changes in endoscopic images and NBI-enlarged findings in the long-term follow-up of a gastric adenocarcinoma of fundic gland type, and this is considered to be a valuable case.
