Multiple early gastric cancer with gastritis cystica profunda showing various histological types.
We report a case of multiple early gastric cancer showing varied histological types associated with gastritis cystica profunda (GCP). A 61-year-old man who had early gastric cancer associated with GCP underwent a distal gastrectomy with lymphadenectomy. Histological examination showed various histological types of cancer -well differentiated, moderately differentiated, poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet ring cell carcinoma- that had developed independently in the mucosal and submucosal layers of the resected specimen. Furthermore, multiple cysts with a single layer of columnar epithelium were present in the submucosa around the cancerous lesions. However, no neoplastic changes were found in those epithelial cells. Helicobacter pylori was detected in the residual stomach 3 months after surgery. Although the mechanism of the relationship between gastric carcinoma and GCPs is obscure, we speculate that repeated erosion and regeneration induced by chronic inflammation causes multicentric carcinogenesis as well as an aberration of the gastric glands. GCPs may be a risk factor for multiple gastric cancer.
Tsuji
Toshiaki
T
Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama 641-8510, Japan.
Iwahashi
Makoto
M
Nakamori
Mikihito
M
Ueda
Kentaro
K
Ishida
Koichiro
K
Naka
Teiji
T
Ojima
Toshiyasu
T
Akamatsu
Hiroko
H
Yamaue
Hiroki
H
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003560:Cysts / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D019160:Endosonography; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery