A CASE OF MINUTE GASTRIC CARCINOID ASSOCIATED WITH TYPE A GASTRITIS, WITH REMARKABLE HYPERGASTRINEMIA

Abstract

This report presents a case of minute gastric carcinoid with type A gastritis which was suspected of gastrinoma and pernicious anemia in the beginning because of the remarkable hypergastrinemia and pancytopenia. A 35-year-old woman were admitted to our hospital for further examination of her pancytopenia. After we ruled out aplastic anemia and pernicious anemia, radiologic and endoscopic examination of total GI tract were done, suspecting of iron deficiency anemia. In the process of examinations, we detected a minute (diameter 5 mm) gastric carcinoid on the anterior wall of middle-gastric body by endoscopic biopsy. Because of her very high serum gastrin level (1, 900ρpg/ml), we suspected gastrinoma initially, however, achlorhydria of gastric juice and a positive test for parietal cell antibody revealed that this hypergastrinemia were due to autoimmnune gastritis (type A gastritis). Though there have been only five reports of gastric carcinoid with type A gastritis including our case in Japanese literatures, the association between both diseases were documented in several Japanese and English literatures, and our case which revealed multiple argyrophil cell hyperplasia and neoplasia of positive Grimelius-stain aound the main lesion was thought to support this hypothesis.