長期間経過を追えた微小胃底腺型胃癌の1例 LONG-TERM FOLLOW-UP OF A GASTRIC ADENOCARCINOMA OF THE FUNDIC GLAND TYPE : A CASE REPORT

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症例は57歳女性.7年前に胃癌に対しESDが施行され,<I>H.pylori</I>除菌後,経過観察中であった.5年前の上部内視鏡検査において,胃体下部大彎前壁に3mmの白色粘膜領域が確認されたが,4年前の鉗子生検では確定診断に至らなかった.3カ月前の上部内視鏡検査での鉗子生検において,胃底腺型胃癌を疑われESDが施行された.病変の病理組織診断は胃粘膜内に限局する胃底腺型胃癌と診断された.免疫組織化学的検討ではペプシノーゲンIが部分的に弱陽性,MUC6がびまん性陽性で,Ki67 indexは3%以下であった.本疾患は近年定義された新しい疾患概念であり,微小病変を長期に観察し得た本症例は稀と考えここに報告する.

A 57-year-old woman had undergone endoscopic submucosal dissection (ESD) for early-stage gastric adenocarcinoma 7 years previously. Subsequently, she received treatment for <I>Helicobacter pylori</I>, and underwent endoscopic follow-up once a year. Two years after ESD, follow-up esophagogastroduodenoscopy revealed a discolored lesion, measuring 3 mm in diameter, at the greater curvature of the lower body of the stomach. Although we performed endoscopic biopsy of the lesion three years later, it was difficult to confirm the diagnosis. Seven years after ESD, gastric adenocarcinoma of fundic gland type was suspected based on a biopsy specimen from the lesion. Hence, we performed ESD. Histological examination of the resected specimen confirmed gastric adenocarcinoma of fundic gland type. The lesion was limited to the mucosa. On immunohistochemical analysis, the lesion was partially positive for pepsinogen-I, and positive for the mucin MUC6 ; the MIB-1 labeling index was ≤ 3%. Gastric adenocarcinoma of fundic gland type has been reported to be a new variant of gastric adenocarcinoma. Herein, we report a rare case of a minute gastric adenocarcinoma of fundic gland type that was followed up over a long period.

収録刊行物

  • 日本消化器内視鏡学会雑誌

    日本消化器内視鏡学会雑誌 57(12), 2639-2646, 2015

    Japan Gastroenterological Endoscopy Society

各種コード

  • NII論文ID(NAID)
    130005115812
  • 本文言語コード
    JPN
  • ISSN
    0387-1207
  • データ提供元
    J-STAGE 
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