2020 Volume 62 Issue 1 Pages 46-52
A 49-year-old woman was referred to our hospital for detailed examination of a gastric polyp. Gastric X-ray examination revealed a polyp in the fornix.
Esophagogastroduodenoscopy revealed a raspberry-like elevated lesion, 5 mm in diameter, in the fornix. The lesion resembled a gastric hyperplastic polyp on endoscopy. Magnified endoscopy with narrow band imaging revealed papillary microstructures of varying size, plus irregularly dilated microvessels within the widened intervening part. Based on biopsy examination, the diagnosis of a mild atypical ductal structure was made. Early gastric cancer was suspected, and endoscopic submucosal dissection of the lesion was performed.
Histopathological examination revealed that the lesion was a well-differentiated tubular adenocarcinoma with low-grade atypism. Immunohistochemical examination showed that the neoplasm was positive for MUC5AC, and negative for MUC6, CD10, and MUC2, indicating that the lesion was a foveolar-type gastric adenocarcinoma.
The patient had no history of Helicobacter pylori (H. pylori) eradication therapy, and she was not infected with H. pylori.
