2021 Volume 54 Issue 8 Pages 514-522
A 76-year-old woman was referred to our hospital for complaints of nausea, loss of appetite, and an upper abdominal mass,. Initially, she was diagnosed with multiple gastric ulcers with Helicobacter pylori infection by upper gastrointestinal endoscopy, and medication was administered. However, reexamination by endoscopy after this treatment revealed type 4 advanced gastric cancer, special type (miscellaneous carcinoma). Additional tests, including immunostaining with anti-lysozyme antibody (lysozyme staining), revealed Paneth cell gastric cancer (World Health Organization classification) and distal gastrectomy was performed. Twenty-two months after the operation, there was no obvious recurrence. Paneth cells are found in gastric mucosa as a result of intestinal metaplasia. Several studies have reported that Paneth cell-like cells containing positive granules that stain with lysozyme are found in gastric cancer tissue during the process of carcinogenesis. However, Paneth cell gastric cancer, in which small tumor cells containing granules in the cytoplasm infiltrate diffusely, as in the present case, is extremely rare.
