Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
A case of severe immune checkpoint inhibitor-related gastritis requiring differential diagnosis from scirrhous carcinoma
Chihiro Kato, Yuichi Morohoshi, Naoto Fukasawa, Sumire Ishino, Tomohiro Fukuda, Yuya Tsunoda, Satoshi Imamura, Shuichi Nagakubo, Yuji Koike, Yuriko Fujita, Yoko Tateishi, Hiroyuki Hayashi, Hirokazu Komatsu
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2023 Volume 103 Issue 1 Pages 77-78

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Abstract

A 90-year-old woman experienced gastritis due to an immune-related adverse event (irAE). Two years earlier, she had been diagnosed with recurrent postoperative lung adenocarcinoma (cT2aN0M1, Stage IV) and had received three courses of pembrolizumab, which she responded well to. However, she suffered from intense abdominal pain and acid reflux after eating for over a year. During a repeated esophagogastroduodenoscopy, the examination revealed stiffness in the gastric wall in the antrum, raising concerns about scirrhous carcinoma. However, biopsy results did not indicate malignancy; instead, they showed severe inflammation, and CD8 antibody staining was positive. Based on clinical and immunopathological assessments, she was diagnosed with irAE gastritis. After initiating steroid treatment, her condition improved significantly, and she fully recovered from her difficulty with oral intake.

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© 2023 Japan Gastroenterological Endoscopy Society Kanto Chapter
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