title: Gastric adenocarcinoma of fundic gland type: Endoscopic and clinicopathological features.
abstract: Gastric adenocarcinoma of fundic gland type (GA-FG) with chief cell differentiation was recently proposed as an extremely rare type of gastric adenocarcinoma. Here, we report 4 cases of GA-FG with chief cell differentiation. Endoscopic features included a submucosal tumor shape or a flat shape, whitish discoloration and dilated vessels on the surface. The tumors were located in the upper or middle third of the stomach. All cases were preoperatively diagnosed as GA-FG by biopsy, and endoscopic submucosal dissection was performed. Resected specimens revealed well-differentiated adenocarcinomas resembling chief cells. Tumor cells were diffusely positive for pepsinogen-I, but partially positive for H(+)/K(+)-ATPase in scattered locations around the tumor margin. Despite the presence of minimal invasion of the carcinoma into the submucosal layer, which was observed in two cases, neither lymphatic nor venous invasion was detected in any of the cases. Finally, all cases showed less aggressive clinical behavior with low grade malignancy.
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui 918-8537, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Tohda
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui 918-8537, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Osawa
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui 918-8537, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Asada
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui 918-8537, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Dochin
authors.affiliation: Gen Tohda, Masaki Dochin, Department of Gastroenterology, Fukui Kosei Hospital, Fukui 918-8537, Japan.
authors.forename: Shintarou
authors.initials: S
authors.lastname: Terahata
keywords: Chief cells; Early gastric cancer; Endoscopic submucosal dissection; Fundic gland type; Low grade malignancy