Gastric squamous metaplasia observed by image‐enhanced endoscopy

Abstract

A 61‐year‐old Helicobacter pylori‐positive female with gastroesophageal reflux disease has undergone surveillance endoscopy every year for 13 years at Tokyo Medical University Hospital. At the first surveillance in 2009, conventional white light endoscopy showed a 10‐mm whitish slightly depressed lesion at the lesser curvature of the gastric cardia. This lesion gradually increased in size to 15 mm over the 13‐year observational period. Indigo carmine chromoendoscopy, narrow band imaging, and texture and color enhancement imaging in both mode 1 and mode 2 clearly emphasized the presence of a depressed whitish mucosa around the gastric mucosa compared with white light imaging. None of the three image‐enhanced endoscopy techniques showed any abnormality in the vascular or structural pattern. Pathological findings showed squamous epithelium without atypia and revealed no evidence of malignancy in the stomach. We thus report a case of gastric squamous metaplasia without gastric neoplastic lesion in the gastric cardia whose lesions were endoscopically observed to change the size for more than 10 years and whose lesions were endoscopically evaluated with a texture and color enhancement imaging mode 1 and mode 2 and narrow band imaging.

Multiple gastric squamous metaplasias with atypical differentiation showing esophageal subepithelial capillary network‐like vessels

“…1 GSM appears as white areas of slightly depressed mucosa, primarily in the cardia and antrum. 2 We describe a 76-year-old woman without notable complaints who underwent an annual esophagogastroduodenoscopy to evaluate atrophic gastritis with Helicobacter pylori infection. Conventional endoscopy showed multiple, slightly depressed, white lesions on the lesser curvature of the cardia (Fig.…”