Abstract
A rare case of early gastric cancer with sarcoid reaction observed in the regional lymph nodes without metastasis and in the stomach wall around the carcinoma tissues is presented.
An 82-year-old woman came to her physician's office because of epigastralgia and was diagnosed as having IIc early gastric cancer at the body of stomach by endoscopic examination. In April 2008, she was admitted to the hospital and underwent distal gastrectomy with D1 + α lymph node dissection. The postoperative pathological diagnosis was poorly differentiated adenocarcinoma with signet-ring cells which was limited within submucosa. No metastasis but numerous epithelioid cell granulomas were observed in the dissected lymph nodes and mucosal layer of the stomach. Bilateral hilar lymphadenopathy was absent and no skin nor ocular lesions were seen in the patient. Serum level of angiotensin converting enzyme was within normal limit.
So far only other five cases of early gastric cancer with sarcoid reaction both in the regional lymph nodes without metastasis and in the stomach wall have been reported in the Japanese literature. The clinical significance of sarcoid reaction is discussed.
