A 46-year-old man who had a gastric polypoid lesion pointed out by gastric mass survey in October 1996, visited a local docter and received upper GI endoscopy. Biopsy specimens from the lesion showed a posssibility of malignancy, so that he was admitted to our department in December 1996.
Endscopic examination founded the semipedunculated lesion with a diameter 5mm in the greater curvature of the upper body, and the lesion was surrounded by the fundic gland mucosa without endoscopic atrophy and intestinal metaplasia. Endoscopic polypectomy was performed. Histological findings of the resected specimen demonstrated very well differentiated tubular adenocarcinoma, and the background fundic gland mucosa had no pathological atrophy and intestinal metaplasia.
Differentiated gastric cancers in fundic gland region without intestinal metaplasia were so rare that their characteristic had not been known very well. We think it may be important to describe the atrophic grade and atrophic border of the stomach, and to use methylene blue when a differentiated gastric cancer is discovered in fundic gland region without atrophy.
