Two cases of adenocarcinoma occurring in sporadic fundic gland polyps observed by magnifying endoscopy with narrow band imaging

Togo, Kazumi; Ueo, Tetsuya; Yonemasu, Hirotoshi; Honda, Hiroki; Ishida, Tetsuya; Tanabe, Hiroshi; Yao, Kenshi; Iwashita, Akinori; Murakami, Kazunari

doi:10.3748/wjg.v22.i40.9028

Cited by 17 publications

(16 citation statements)

References 15 publications

(20 reference statements)

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“…8 A recent series reported red and semi-pedunculated gastric adenocarcinomas arising in normal mucosa. 9,10 In this patient, the color and shape of the malignancy seen with white light imaging were similar to those seen in hyperplastic polyps in H. pylori-positive mucosa. However, LCI showed endoscopic findings consistent with a malignant lesion and a background different from hyperplastic polyps.…”

supporting

confidence: 60%

“…These findings of surface pattern have been observed in several patients with similar malignant lesions and play an essential role in distin-guishing this type of cancer from a benign polyp. 9,10 We reported that early gastric cancers show orange-red, orange-white, and purple colors using LCI. 3 It is noted that red cancers imaged with white light imaging change to purple with LCI.…”

mentioning

confidence: 99%

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Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa

et al. 2021

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confidence: 60%

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confidence: 99%

Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa

et al. 2021

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“…Gastric fundic gland polyp (FGP)-associated dysplasia/adenocarcinoma could be one of the differential diagnoses, because the neoplastic epithelium shows foveolar differentiation in our cases as well as in fundic gland polyps 17 20 . Gastric FGP reportedly rarely accompanies gastric cancer and has endoscopic and histologic findings quite similar to those in our cases 20 . However, as shown in Fig.…”

Section: Discussionmentioning

confidence: 81%

Gastric foveolar-type adenomas endoscopically showing a raspberry-like appearance in the Helicobacter pylori-uninfected stomach

et al. 2019

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Background and study aims Foveolar-type adenoma is described as a very rare tumor that occurs in individuals without Helicobacter pylori (HP) infection and diagnosed as adenocarcinoma in the Japanese Classification of Gastric Carcinoma (JCGC). However, we have frequently encountered patients with foveolar-type adenoma that endoscopically resembles a hyperplastic polyp, suggesting that it has just been overlooked to date. Here, we analyzed clinicopathological characteristics of a special subtype of foveolar-type adenoma showing specific endoscopic findings. Patients and methods From a total of 212 patients with gastric cancer resected during a 22-month period, we enrolled 14 (6.6 %) diagnosed with foveolar-type adenoma (adenocarcinoma in JCGC). HP infection status was determined by eradication history, HP serum IgG antibody level, urea breath test, and endoscopic and histological findings. All lesions were observed using white-light endoscopy and narrow-band imaging with magnification endoscopy (NBIME). Endoscopically resected lesions were histologically examined. Results None of 14 patients had a current or past history of HP infection. All lesions were visualized on non-atrophic gastric mucosa as small reddish protrusions with fine granular surface, showing a raspberry-like appearance. NBIME showed papillary or gyrus-like microstructures with irregular capillary. Lesions were histologically diagnosed as foveolar-type adenoma showing MUC5AC-positive gastric mucin phenotype. Ki-67 was overexpressed (median labeling index 69.9 %, range 28.4 – 92.1 %), though all lesions were an intraepithelial tumor without stromal invasion. p53 over-staining was not seen in any. Conclusions Raspberry-like lesions on non-atrophic gastric mucosa in HP-uninfected individuals should be evaluated for the possibility of a special subtype of foveolar-type adenoma.

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“…HGD was equivalent to category 4 according to the Vienna classification, and classified as noninvasive intramucosal carcinoma according to the JCGC . Although there have been a few case reports of FGP with HGD/ intramucosal adenocarcinoma, deeper invasive adenocarcinoma arising in FGP has never been reported.…”

Section: Discussionmentioning

confidence: 99%

No transformation of a fundic gland polyp with dysplasia into invasive carcinoma after 14 years of follow‐up in a proton pump inhibitor‐treated patient: A case report

Fukuda

Ishigaki

Ban

et al. 2018

Pathology International

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A fundic gland polyp (FGP) is a common gastric polyp. Intraepithelial neoplasia in FGPs, referred to as FGP with dysplasia, is often seen in patients with familial adenomatous polyposis (FAP). In sporadic FGPs, low‐grade dysplasia (LGD) is rare, and high‐grade dysplasia (HGD) or carcinoma arising from sporadic FGPs is extremely rare. Because of this rarity, the prognosis and appropriate management of these lesions have not been clarified. In the present case, a sporadic FGP with LGD did not develop into invasive carcinoma, but contained foci of HGD 14 years after diagnosis. The biopsy specimen of the polyp taken at the first esophagogastroduodenoscopy 15 years earlier was diagnosed as FGP without dysplasia. At the second histological examination, LGD was found. Because the polyp increased in size during proton pump inhibitor therapy for 14 years, endoscopic mucosal resection was performed. The pathological diagnosis of the resected specimen was FGP with HGD mixed in LGD, with no invasive carcinoma. Dysplasia in FGPs might have less malignant potential regardless of dysplasia or size.

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Two cases of adenocarcinoma occurring in sporadic fundic gland polyps observed by magnifying endoscopy with narrow band imaging

Cited by 17 publications

References 15 publications

Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa

Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa

Gastric foveolar-type adenomas endoscopically showing a raspberry-like appearance in the Helicobacter pylori-uninfected stomach

No transformation of a fundic gland polyp with dysplasia into invasive carcinoma after 14 years of follow‐up in a proton pump inhibitor‐treated patient: A case report

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