Low-grade differentiated adenocarcinoma of the gastric foveolar type arising in the helicobacter pylori -negative stomach

患者は36歳,男性.心窩部痛を主訴に受診し,上部消化管内視鏡検査で,萎縮のない粘膜を背景とした胃体上部大弯に,5mm大の山田II型ポリープを認めた.Helicobacter pylori 感染は陰性であった.生検組織の病理診断は,胃型粘液形質の低異型度分化型腺癌で,腫瘍細胞はMUC5AC陽性細胞が主体であり,胃腺窩上皮型癌と診断された.後日施行した内視鏡的粘膜切除後の標本に腫瘍は認めなかったため,生検により腫瘍部は完全切除されたものと推定された.

A 36-year-old man who complained upper abdominal pain was referred to our hospital. Esophagogastroduodenoscopy indicated a Y-II type polyp, 5 mm in diameter, on the greater curvature of the upper gastric body. There was no atrophy of the gastric mucosa, and anti-Helicobacter pylori antibody was negative. Biopsy revealed a low-grade differentiated adenocarcinoma with gastric phenotype expression. MUC5AC was predominantly expressed in the tumor, so we diagnosed adenocarcinoma of the gastric foveolar type. The tumor was completely resected by biopsy. There was no tumor in a specimen retrieved by endoscopic mucosal resection. This was a rare case of low-grade differentiated adenocarcinoma of the gastric foveolar type arising in a Helicobacter pylori -negative stomach.

Helicobacter pylori 陰性

低異型度分化型癌

胃型

胃腺窩上皮型