title: A case of early gastric cancer in which the degree of histological atypia was correctly predicted by magnifying endoscopy combined with narrow band imaging.
abstract: We herein report a case of early gastric cancer with mixed components having different grades of atypia, which was correctly predicted by magnifying endoscopy combined with narrow band imaging. A 67-year-old man had a flat elevated lesion (0-IIa) in the anterior wall of the gastric antrum. With narrow band imaging, a flat lateral extension (0-IIb), not recognized with white light imaging was seen in the anal side of the main tumor. Magnifying endoscopy combined with narrow band imaging saw a relatively regular fine network pattern of micro-vessels in the surface of the 0-IIa area. However, in the surface of the 0-IIb area, a villous structure with villi of various size and heterogeneity, micro-vessels showing tortuousity were observed. We judged the grade of atypia to be higher in the 0-IIb area than in the 0-IIa area. Histological examination of the resected specimen verified the 0-IIa area and 0-IIb area as adenoma and adenocarcinoma, respectively.
authors.affiliation: Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan. hirasawa@openhp.or.jp
authors.forename: Dai
authors.initials: D
authors.lastname: Hirasawa
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.forename: Taku
authors.initials: T
authors.lastname: Yamagata
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Noda
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D003937:Diagnosis, Differential; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D013274:Stomach Neoplasms / Q000175:diagnosis*