Inverted gastric adenocarcinoma of fundic gland mucosa type colliding with well differentiated adenocarcinoma

Takahashi, Keitaro; Fujiya, Mikihiro; Ichihara, Shin; Moriichi, Kentaro; Okumura, Toshikatsu

doi:10.1097/md.0000000000007080

Cited by 15 publications

(19 citation statements)

References 10 publications

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“…Microscopically, OGAs show either a chief cell‐predominant pattern (Figure 7A) or an admixture of chief and parietal cells resembling fundic glands (Figure 7B). Foveolar and mucous neck cell differentiation (Figure 7C) can be seen in larger tumours, and could represent a more biologically aggressive phenotype 67–69 . Mild to moderate nuclear atypia is seen in small lesions, whereas larger OGAs show high‐grade nuclear atypia along with complex trabecular/glandular anastomosing or cribriform architecture.…”

Section: Stomachmentioning

confidence: 99%

Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum

et al. 2021

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Non-conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrumThe increasing use of gastrointestinal endoscopic procedures has led to the recognition by histopathologists of non-conventional (or special-type) dysplasias of the gastrointestinal tract. These lesions can be recognised in association with prevalent underlying gastrointestinal conditions, such as Barrett oesophagus, chronic atrophic gastritis, and inflammatory bowel disease. The diagnosis of these special types can be challenging, and their biological behaviours are not fully characterised. The aim of this review is to provide a global view of non-conventional dysplastic lesions observed in the various segments of the tubular gastrointestinal tract and describe their salient features. Furthermore, as the clinical implications of these various subtypes have not been broadly tested in practice and are not represented in most management guidelines, we offer guidance on the best management practices for these lesions.

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Section: Stomachmentioning

confidence: 99%

Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum

et al. 2021

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“…Apart from our case, only 9 cases of GF-FGM have been reported, of which 8 showed submucosal invasion and 1 was limited to the lamina propria. [ 3 – 5 ] This indicates the tendency of this tumor to invade to submucosa, similar to FG-GM. [ 6 ] However, no case was localized in the submucosa.…”

Section: Discussionmentioning

confidence: 89%

“…[ 3 ] So far, only 9 cases of GA-FGM have been reported. [ 3 – 5 ] GA-FG typically shows an elevated lesion similar to a submucosal tumor, and it often infiltrates into the submucosal layer and has a small diameter. [ 6 ] According to most of the previous reports on GA-FGM, this tumor shows submucosal invasion.…”

Section: Introductionmentioning

confidence: 99%

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Gastric adenocarcinoma of fundic gland mucosa type localized in the submucosa

Uchida¹,

Ozawa²,

Ueda³

et al. 2018

Medicine

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Rationale:Gastric adenocarcinoma of fundic gland type (GA-FG) is a new histological type of gastric cancer manifesting with differentiation into a fundic gland. Furthermore, gastric adenocarcinoma of fundic gland mucosa type (GA-FGM) is a tumor that shows differentiation into not only a fundic gland but also foveolar epithelium and a mucous gland. These tumors tend to invade the submucosal layer. However, no cases of these tumors being localized only in the submucosa have been reported. Here, we present a case of GA-FGM localized in the submucosa and describe the cytological features of this tumor. To our knowledge, this is the first reported case of GA-FGM localized in the submucosa.Patient concerns:A man in his early 70s was referred to our institution because of the detection of a gastric submucosal tumor during a health checkup.Diagnoses:Gastric adenocarcinoma of fundic gland mucosa type.Interventions:Endoscopic ultrasound-guided fine-needle aspiration (FNA), endoscopic submucosal dissection (ESD), and total gastrectomy with lymph node dissection were performed.Outcomes:The FNA specimen showed epithelial cells with low-grade atypia. In the ESD specimen, adenocarcinoma showing a gastric fundic gland mucosa-like morphology was observed. Immunohistochemical analysis showed positive staining for pepsinogen I, H+/K+-adenosine triphosphatase, MUC6, and MUC5AC and negative staining for MUC2 and CD10, indicating tumor differentiation into fundic gland mucosa. Therefore, the tumor was diagnosed as GA-FGM, with localization in the submucosal layer. Total gastrectomy and lymph node dissection were performed because of the positive margins of the ESD specimen. Neither residual tumor nor lymph node metastasis was detected; however, many foci of heterotopic gastric glands (HGGs) were observed in the gastric wall, suggesting that GA-FGM arose from an HGG. After treatment, no recurrence was observed during a 1-year follow-up period.Lessons:Various tumors may arise from HGGs. Furthermore, when an FNA specimen shows gastric fundic gland mucosa-like epithelial cells with weak atypia, the possibility of GA-FG and GA-FGM should be considered.

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“…34 Microscopically, OGAs can display a chief cell-predominant pattern, an admixture of chief and parietal cells resembling normal fundic glands, and a predominant mucous neck cell and foveolar differentiation pattern. 34,57,58 The latter subtype is usually observed in larger lesions, which could represent a more aggressive variant. 34 Architecturally, OGAs are composed of tightly packed tubules and trabeculae.…”

Section: Oxyntic Gland Adenomamentioning

confidence: 99%

The pathology of gastric and duodenal polyps: current concepts

2020

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The liberal use of upper endoscopy has led to an increased detection of gastric and duodenal polyps, which are identified in as many as 6 and 4.6% of patient examinations, respectively. Gastroduodenal polyps are a heterogeneous group of lesions that can be neoplastic or non‐neoplastic (e.g. hyperplastic or heterotopical). Most polyps present characteristic topographical features, as well as endoscopic appearance and size. Evaluation of the surrounding mucosa is essential in assessing the underlying pathology (e.g. Helicobacter pylori, autoimmune gastritis or inherited polyposis syndromes). Phylogenetically, gastric and duodenal polyps can be classified according to the epithelial compartment from which they derive. Polyps that arise from the surface epithelium can either be of foveolar or intestinal type, and they can develop from either the native mucosa or the metaplastic epithelium (gastric intestinal metaplasia or duodenal foveolar metaplasia). Other polyps develop from the deeper glandular component, such as pyloric/oxyntic gland derived subtypes. In this review we focus upon epithelial polyps, with an emphasis on the most common and clinically relevant lesions, and present recently described entities.

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Inverted gastric adenocarcinoma of fundic gland mucosa type colliding with well differentiated adenocarcinoma

Cited by 15 publications

References 10 publications

Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum

Non‐conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum

Gastric adenocarcinoma of fundic gland mucosa type localized in the submucosa

The pathology of gastric and duodenal polyps: current concepts

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