Carcinoma with Lymphoid Stroma of the Remnant Stomach That Derived from Gastritis Cystica Polyposa

Abstract

A 47-year-old man received distal gastrectomy with Billroth-II reconstruction for duodenal ulcer 33 years previously. He presented to our hospital with monoclonal gammopathy. An abnormal uptake in the stomach was pointed out and the patient underwent PET-CT in order to exclude the possibility of malignant lymphoma. Esophagogastroduodenoscopy found a torose mucosal polypoid lesion with the irregular ulcerative lesion at the portal side of the gastrojejuno anastomosis. It was diagnosed as well-differentiated adenocarcinoma. He underwent total remnant gastrectomy for residual gastric cancer. The extension of the gastric pit and the hyperplasia of glands and the cystic mucus glands similar to the pyloric gland were recognized and regarded as gatritis cystica polyposa (GCP) histopathologically. An image of the lymphocyte infiltration cancer with EB virus (EBV) infection at the surface layer of GCP was observed. The amplification of EB encoded a small RNA1 (EBER-1) gene in the nucleus of tumor cells was recognized. Here we report a case of EBV-associated lymphocyte infiltration cancer that derived from GCP.