Utility of magnifying endoscopy with narrow-band imaging for detection of gastric cancer in hyperplastic polyps

Abstract

A 77-year-old man, who had undergone a distal gastrectomy in 1997 because of advanced gastric cancer, was referred to our hospital for endoscopic resection of a metachronous gastric cancer. Upper gastrointestinal endoscopy revealed a 20-mm reddish polyp located at the greater curvature of the gastrectomy site of the residual stomach.
Magnifying endoscopy with narrow-band imaging (ME-NBI) revealed a regular structure at the anal side of the polyp, resembling a hyperplastic polyp. Thus, irregular surface and vascular structure were observed at the oral side of polyp, indicating gastric cancer. In addition, we noted a gradual gradation between the hyperplastic lesion and the cancerous lesion by ME-NBI. Considering all these findings, we speculated that the hyperplastic polyp had progressed to adenocarcinoma. Endoscopic mucosal resection was performed, and histological analysis confirmed the diagnosis of adenocarcinoma. Thus, ME-NBI can be useful for detection of gastric cancer developing in hyperplastic polyps.