A case of raspberry-like foveolar-type gastric adenocarcinoma resected by strip biopsy

症例は38歳,男性.近医で施行された上部消化管内視鏡検査で,胃穹窿部に隆起性病変を認めた.生検でGroup4であったため,精査加療目的に当院を紹介受診した.当院での上部消化管内視鏡検査では胃穹窿部にラズベリー様の5mm大の発赤調,亜有茎性の隆起性病変を認めた.背景粘膜に萎縮性胃炎は認めず,Helicobacter pyloriは陰性であった.Strip biopsy法により内視鏡的に切除を行い,病理組織学的には腺窩上皮型胃癌であった.本邦報告例では,ラズベリー様腺窩上皮型胃癌は,数mm大の粘膜内癌で,一般的にESDの治療難易度が高いとされるU,M領域の大彎や胃穹窿部に発見されており,簡便に短時間で治療が可能であるStrip biopsy法の良い適応と考える.今回,Strip biopsy法で切除したラズベリー様腺窩上皮型胃癌の1例を経験したので,文献的考察を加え報告する.

A 38-year-old man was referred to our hospital for detailed examination of a gastric polyp which was suspected to be early gastric cancer. Esophagogastroduodenoscopy revealed a semipedunculated polyp in the fornix. The shape of the polyp was like a raspberry. There was no atrophy of the gastric mucosa, and anti-Helicobacter pylori antibody was negative. Strip biopsy was performed, pathological examination showed that the lesion was a foveolar-type gastric adenocarcinoma. Complete en bloc resection was achieved, in accordance with the current Japanese guidelines. Raspberry-like foveolar-type gastric adenocarcinomas have been found as intramucosal carcinoma of a few millimeters in size and is a good indication for strip biopsy. We reported a case of foveolar-type gastric adenocarcinoma resected by strip biopsy with a review of the literature.

腺窩上皮型胃癌　

ラズベリー様　

Strip biopsy

Helicobacter pylori