2021 Volume 63 Issue 8 Pages 1501-1507
A 77-year-old woman presented with epigastric pain and underwent upper gastrointestinal endoscopy. Five early-stage gastric cancers were found in the stomach. Background endoscopic findings of the gastric mucosa showed an intestinal metaplasia in the antrum. A clear vascular image was obtained from the gastric body to the fornix, and atrophic changes were observed. Fasting serum gastrin and serum anti-H. pylori-IgG antibody levels were 410 pg/ml and＜3.0U/ml, respectively. Anti-parietal cell antibody (measured 80 times) and anti-intrinsic factor antibody were positive. Background histological findings of gastric mucosa showed marked atrophic changes and intestinal metaplasia in the pyloric gland. The proper fundic gland was absent. Moreover, intestinal metaplasia, an endocrine cell micronest, and enterochromaffin-like cells hyperplasia were observed. Therefore, we diagnosed autoimmune gastritis based on the endoscopic and serological findings.
This case is an autoimmune gastritis with atrophy and intestinal metaplasia in the pyloric gland area, and it is possible that the five gastric cancers developed from the background gastric mucosa.
