Abstract
A 72-year-old woman had a Billroth I partial gastrectomy for gastric ulcers. Sixteen years later, she visited hospital for dizziness, due to anemia. Endoscopic examination showed a pedunclated polypoid lesion on the gastrojejunostomy site. The biopsy specimens from the polypoid lesion revealed only hyperplastic foveolar epithelium. However, four months later, the polypoid lesion increasd in size and a deformity was demonstrated by gastroscopy. Histologically, the lesion was diagnosed as a well differentiated adenocar-cinoma, and total gastrectomy was performed. The resected specimen showed that proper muscle layer with muscularis mucosae occupied central portion of the stalk. The caudal portion of the polypoid lesion consisted of many cystically dilatated glands. This his-tological features were similar to the gastritis cystica polyposa (GCP). Cancer cells of well -differented type were completely surrounded by the cystically dilated glands. This case was remarkably different from previously reported cases. Therefore, mechanical factors regarding the previous operation, but not bile reflux, may be related to the development of GCP. These findings indicated that GCP may play an important role in the development of gastric cancer in the gastric remnant.
