Development of an inveterate gastroduodenal ulcer caused by antral G-cell hyperplasia of the stomach (pseudo-Zollinger-Ellison Syndrome): report of a case.
We describe herein the case of a 54-year-old Japanese woman in whom an inveterate peptic ulcer developed in association with pseudo-Zollinger-Ellison Syndrome (pseudo-ZES). The patient presented with weight loss and abdominal distension caused by antral and duodenal stenosis due to an inveterate peptic ulcer. Her serum gastrin level was very high; however, no evidence of a gastrinoma or carcinoid tumor was detected by preoperative examinations or surgery. A total gastrectomy and double-tract reconstruction was performed, and pathological examination revealed a gastric ulcer (UL-IV) with no histopathological evidence of a neoplasm. Immunohistochemical staining showed an obvious increase in the number of endocrine cells that were positive for chromogranin A, and marked G-cell hyperplasia was observed in the antral mucosa. Furthermore, the number of enterochromaffin-like cells was remarkably high. From the results of the immunohistochemical examination, the patient was diagnosed as having hypergastrinemia due to antral G-cell hyperplasia. Postoperatively, the patient's serum gastrin level fell rapidly to within the normal range, her nutritional status improved, and her weight increased by about 10 kg within 1 year.
Takeno
S
S
Department of Surgery II, Oita Medical University, Japan.
Noguchi
T
T
Kubo
N
N
Sato
T
T
Uchida
Y
Y
Moriuchi
A
A
D003937:Diagnosis, Differential; D005260:Female; D005743:Gastrectomy; D019863:Gastrin-Secreting Cells / Q000473:pathology*; D015408:Gastrinoma / Q000175:diagnosis; D005755:Gastrins / Q000097:blood*; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D008875:Middle Aged; D010437:Peptic Ulcer / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011706:Pyloric Antrum / Q000473:pathology; D016896:Treatment Outcome; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis
D005755:Gastrins