title: Superficially elevated-type serrated hyperplastic lesion of the stomach with minute adenocarcinoma.
abstract: We report a case of gastric serrated hyperplastic lesion with minute adenocarcinoma. A 65-year-old Japanese man underwent endoscopic submucosal dissection to the superficially elevated-type (0-IIa) lesion located at the lesser curvature of the gastric angle. Histological observation revealed hyperplastic change of foveolar epithelium with serrated glandular structure as well as a minute tubular adenocarcinoma component. Immunohistochemically, the lesion demonstrated gastrointestinal, predominantly gastric, phenotype (MUC5AC++, MUC6+, MUC2+, CD10-). Positive p53 immunoreactivity was detected in the carcinoma component of the lesion with a point mutation (G877T; R209I) of the gene and microsatellite instability of the BAT-RII locus; however, immunoreactivity of the mismatch repair gene product hMLH1 was well preserved in the cancer as well as in the hyperplastic lesion. The hyperplastic lesion with serrated glandular pattern would be a precancerous lesion of adenocarcinoma of the stomach.
authors.affiliation: Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, chuo-ku, Kobe, Japan.
authors.forename: Tadateru
authors.initials: T
authors.lastname: Hasuo
authors.forename: Shuho
authors.initials: S
authors.lastname: Semba
authors.forename: Shinya
authors.initials: S
authors.lastname: Satake
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shirasaka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Aoyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokozaki
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy; D000368:Aged; D004210:Dissection; D005773:Gastroscopy; D006801:Humans; D006965:Hyperplasia; D008297:Male; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy