An 80-year-old woman with a past history of Helicobacter pylori eradication underwent esophagogastroduodenoscopy for screening. A whitish-elevated lesion with submucosal tumor-like shape, 15 mm in size, was detected on the upper third of the stomach. A reddish depressed area was observed in the central part of the lesion. Magnifying endoscopy with narrow-band imaging (M-NBI) revealed an irregular microvascular/ microsurface pattern with a demarcation line in the reddish depressed area, and a regular microvascular/ microsurface (circular marginal crypt epithelium, dilatation of the intervening part) pattern without a demarcation line in the whitish elevated area. The pathological diagnosis of the ESD specimen was gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM), pT1b/SM1 (50 μm). M-NBI may be useful for preoperative diagnosis of GA-FGM.
