2024 Volume 66 Issue 1 Pages 50-55
This case study involves a 64-year-old male patient with an elevated lesion characterized by irregular depression located on the anterior wall of the gastric angle. The background mucosa displayed of fundic gland without atrophy and no intestinal metaplasia. The lesion, characterized by irregular microvascular pattern and micro-surface patterns was diagnosed as a well-differentiated tubular adenocarcinoma. Subsequently, the patient underwent ESD. Pathological analysis confirmed the presence of well-differentiated tubular adenocarcinoma, particularly classified as intramucosal carcinoma. Immunohistochemical staining was negative for MUC5AC and MUC6, but positive for MUC2, CDX2, and CD10, indicating a small intestinal phenotype within the lesion. The patient tested negative for H. pylori in the histological examination and had no history of H. pylori eradication. Based on the results of these blood tests for H. pylori, together with the pepsinogen test and endoscopic findings, it was determined that the patient was not infected with H. pylori. Since there is no previous report of a case of well-differentiated tubular adenocarcinoma with small intestinal phenotype arising from H. pylori uninfected fundic gland mucosa, we report this case with a review of the literature.
