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Gastric adenocarcinoma of fundic gland type with autoimmune gastritis

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Abstract

An 87-year-old man with dysphagia presented to our hospital. He was diagnosed with autoimmune gastritis (AIG) with severe atrophy and hypergastrinemia. The patient was positive for parietal cell antibody (PCA) and anti-intrinsic factor antibody (IFA), without evidence of H. pylori infection. A flat elevated tumor was detected in the middle corpus, and therapeutic endoscopic submucosal dissection was performed. Histopathological examination revealed atypical cells mimicking the fundic glands, which were positive for pepsinogen-I and partially positive for MUC6 and H + /K + -ATPase, proliferating to the deep layer. The final diagnosis was gastric adenocarcinoma of the fundic gland type (GAFG). AIG is expected to be difficult to develop GAFG because the basal gastric glands are highly atrophic due to the production of PCA. However, some chief cells may remain and could have the potential to develop into malignancy during AIG progression. Therefore, careful observation is required in patients with AIG when considering the occurrence of GAFG.

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Data availability

This is a case report and there is no data set to disclose.

Abbreviations

AIG:

Autoimmune gastritis

PCA:

Parietal cell antibodies

GAFG:

Gastric adenocarcinoma of the fundic gland type

ESD:

Endoscopic submucosal dissection

H. pylori :

Helicobacter pylori

GAFGM:

Gastric adenocarcinoma of the fundic gland mucosa type

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Acknowledgements

The authors wish to thank Dr. Yasuo Okura for the comments on pathology.

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Authors and Affiliations

  1. Gastroenterology Medicine Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan

    Chihiro Sumida, Chikamasa Ichita & Akiko Sasaki

  2. Department of Pathology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan

    Wataru Naito & Mitsuru Yanai

  3. Department of Pathology, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan

    Mitsuru Yanai

Authors
  1. Chihiro Sumida
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  2. Chikamasa Ichita
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  3. Wataru Naito
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  4. Mitsuru Yanai
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  5. Akiko Sasaki
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Correspondence to Chihiro Sumida.

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All procedures were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Sumida, C., Ichita, C., Naito, W. et al. Gastric adenocarcinoma of fundic gland type with autoimmune gastritis. Clin J Gastroenterol 16, 146–151 (2023). https://doi.org/10.1007/s12328-022-01747-w

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  • DOI: https://doi.org/10.1007/s12328-022-01747-w

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