Multifocal Adenocarcinomas Arising within a Gastric Inverted Hyperplastic Polyp
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
We present herein the occurrence of multifocal adenocarcinomas with a minute signet ring cell carcinoma that arose within a gastric inverted hyperplastic polyp (IHP) in a 40-year-old woman. Endoscopic ultrasonography demonstrated a heterogeneous hypoechoic mass in the third layer of the gastric wall. The endoscopic submucosal dissection specimen measuring 3.5×3.2×1.8 cm was a well-circumscribed protruding lesion that had a slit-shaped cavity. Histologically, the lesion consisted mainly of endophytic proliferation of hyperplastic columnar cells resembling normal foveolar epithelium. In addition, six foci of adenocarcinomas and a minute focus of signet ring cell carcinoma were randomly distributed in the superficial and deep regions. The adenocarcinoma was gradually transitioning from dysplasia, while the signet ring cell carcinoma was surrounded by hyperplastic foveolar epithelium. This is the first report of a gastric IHP with multifocal intramucosal adenocarcinomas and a signet ring cell carcinoma, and endoscopic submucosal dissection is used to completely resect it.
Abstract
We present herein the occurrence of multifocal adenocarcinomas with a minute signet ring cell carcinoma that arose within a gastric inverted hyperplastic polyp (IHP) in a 40-year-old woman. Endoscopic ultrasonography demonstrated a heterogeneous hypoechoic mass in the third layer of the gastric wall. The endoscopic submucosal dissection specimen measuring 3.5×3.2×1.8 cm was a well-circumscribed protruding lesion that had a slit-shaped cavity. Histologically, the lesion consisted mainly of endophytic proliferation of hyperplastic columnar cells resembling normal foveolar epithelium. In addition, six foci of adenocarcinomas and a minute focus of signet ring cell carcinoma were randomly distributed in the superficial and deep regions. The adenocarcinoma was gradually transitioning from dysplasia, while the signet ring cell carcinoma was surrounded by hyperplastic foveolar epithelium. This is the first report of a gastric IHP with multifocal intramucosal adenocarcinomas and a signet ring cell carcinoma, and endoscopic submucosal dissection is used to completely resect it.
참고문헌 (14)
- Kamata Y, "An unusual heterotopia of pyloric glands of the stomach with inverted downgrowth", Acta Pathol Jpn, 43, pp.192~197 (1993)
- Kono T, "Adenocarcinoma arising in gastric inverted hyperplastic polyp: a case report and review of the literature", Pathol Res Pract, 203, pp.53~56 (2007)
- Sobin LH, "Inverted hyperplastic polyps of the colon", Am J Surg Pathol, 9, pp.265~272 (1985)
- Yantiss RK, "Hyperplastic polyp with epithelial misplacement (inverted hyperplastic polyp): a clinicopathologic and immunohistochemical study of 19 cases", Mod Pathol, 14, pp.869~875 (2001)
- Itoh K, "Unusual gastric polyp showing submucosal proliferation of glands: case report and literature review", J Gastroenterol, 33, pp.720~723 (1998)
- Yamashita M, "Gastric inverted hyperplastic polyp: report of four cases and relation to gastritis cystica profunda", APMIS, 110, pp.717~723 (2002)
- 최민성, "함몰증식성폴립에 동반된 심재성 낭종성 위염과 조기위암1예", The Korean Journal of Pathology, 41(1), pp.55~58 (2007), 대한병리학회
- Shibahara K, "A case of gastric hyperplastic polyp with malignant transformation", Hepatogastroenterology, 52, pp.319~321 (2005)
- Yao T, "Malignant transformation of gastric hyperplastic polyps: alteration of phenotypes, proliferative activity, and p53 expression", Hum Pathol, 33, pp.1016~1022 (2002)
- Hirasaki S, "Minute signet ring cell carcinoma occurring in gastric hyperplastic polyp", World J Gastroenterol, 13, pp.5779~5780 (2007)
- Wu CH, "Signet-ring type adenocarcinoma arising from a tiny gastric polyp", Gastrointest Endosc, 67, pp.724~725 (2008)
- Fry LC, "Signet-ring-cell adenocarcinoma arising from a hyperplastic polyp in the stomach", Gastrointest Endosc, 61, pp.493~495 (2005)
- Gotoda T., "Endoscopic resection of early gastric cancer", Gastric Cancer, 10, pp.1~11 (2007)
- Gotoda T, "A large endoscopic resection by endoscopic submucosal dissection procedure for early gastric cancer", Clin Gastroenterol Hepatol, 3(7 Suppl 1), pp.71~73 (2005)