摘要
A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy.Four years prior,she was diagnosed with a Helicobacter pylori infection but no eradication was performed.The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma.Endoscopic submucosal dissection(ESD)was performed.Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae.These tumor cells expressed focally pepsinogen-Ⅰ,diffusely MUC6,and scattered H^+/K^+ATPase according to immunohistochemistry.Therefore,we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG).Adjacent to the GA-FG,proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed.Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma.To the best of our knowledge,this is the first case report of GA-FG with a signet-ring cell carcinoma component.The origin of signet-ring cell carcinoma,i.e.,whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present.We expect the accumulation of similar cases and further analysis to clarify this issue.
作者简介
Correspondence to:Keita Kai,MD,PhD,Associate Professor,Department of Pathology,Saga University Hospital,Nabeshima 5-1-1,Saga City,Saga 849-8501,Japan.kaikeit@cc.saga-u.ac.jp.Telephone:+81-952-343264,Fax:+81-952-342055.(0000-0003-1553-2598);Masaaki Satake(0000-0003-2264-8687);Osamu Tokunaga(0000-0002-4976-1148).
