PEDUNCULATED GASTRIC CARCINOID TUMOR IN ASSOCIATION WITH TYPE A GASTRITIS

-REPORT OF A CASE AND REVIEW OF THE JAPANESE LITERATURE-

Abstract

A 52-year old female was admitted to our hospital, because of abnormal findings on an upper Gl series roentgenography for gastric cancer. Roentgenography and endoscopy showed a pedunculated polyp incarcerating into the duodenal bulb from the middle body and several small elevated lesions at the middle and upper body of the stomach. Endoscopic polypectomy was performed for the pedunculated polyp. Specimens of resected polyp and biopsy from small elevated lesions were histologically carcinoid tumors. Total gastrectomy was done. Preoperative laboratory findings showed hypergastrinemia and anacidity and were positive for anti-parietal cell antibodies. Serum level of gastrin taken from a vein of the antrum during the operation was very high. Histopathological findings revealed that G-cells in the antrum were hyperplastic, and the fundic glands were atrophic. Hyperplasia of enterochromaffin-like cell, endocrine cell micronests and many micro carcinoid tumors were histopathologically observed in the corpus. This case may indicate to elucidate the development of carcinoid tumor. We also reviewed the literature on multiple gastric carcinoid tumors in Japan.