Abstract
There have been several reports suggesting a relationship between pernicious anemia and carcinoid tumor of the stomach. This paper reports on the occurrence of gastric polyposis with carcinoid tumor and type A gastritis which often leads to pernicious anemia. A 49 y. o. Japanese male, under medical observation for gastric polyposis for 10 years, was admitted to our hospital because the biopsy from one of these polyps was diagnosed as carcinoid tumor. Physical examination and laboratory studies were all negative except for moderately elevated gastrin level (570 pg/ml), a positive test for parietal cell antibody (PCA) and markedly reduced acid secretion (MAO : 0.20 mEq/hr). Radiologic and endoscopic examination of the stomach showed polyposis in the body but not in the antrum. Argyrophilic carcinoid tumor was located on the greater curvature of the upper body and was removed by wedge resection. Endoscopic Congo-red test showed blue-black changes only on the top of some polyps while methylene-blue test showed dye absorption only on the mucosa surrounding these polyps and on the fornical mucosa. Endoscopic biopsy revealed an increased number of argyrophilic cells in the fundic mucosa with G cell hyperplasia in the antral mucosa. Oxyntic glands were well preserved on the top of the polyps in contrast to the atrophic mucosa around the polyps. Hence, a relationship is suggested between type A gastritis and gastric carcinoid tumor. The polyposis can be properly called as "pseudopolyposis" duo to the atrophic changes by the type A gastritis.
