Abstract
Two patients with intestinal metaplasia of the stomach, whose distribution was exclusively confined to the fundic gland area, are presented herein. The first, a 51-year-old male, had been treated for pernicious anemia for 14 years when he was found to have gastric cancer. His serum gastrin level was quite high, whereas his gastric acid output was markedly low. The polypoid cancer in the fornix of the stomach, which had been removed endoscopically, revealed tubular adenocarcinoma with its invasion limited to the mucosa. The resected stomach showed no residual carcinoma but had numerous minute foci of intestinal metaplasia, diffusely distributed but exclusively confined to the fundic gland area, by macroscopic observation using the leucine aminopeptidase-alkaline phosphatase double staining method. The intestinal metaplasias were all of the complete type, and the parietal and chief cells were almost completely lost. The second patient, a 76-year-old male without pernicious anemia, underwent total gastrectomy for two polypoid cancers in the body of the stomach. The resected specimens, in addition to two hyperplastic polyps in the transitional area, showed the same distribution of intestinal metaplasia as seen in the first patient.
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Hirono M. A clinicopathological study on intestinal metaplasia of the human stomach using leucine aminopeptidase-alkaline phosphatase double staining method. Hiroshima Daigaku Igaku Zasshi (Med J Hiroshima Univ) 1986; 34: 313–329. (English Abst.)
Correa P. Precursors of gastric and esophageal cancer. Cancer 1982; 50: 2554–2565.
Varis K, Ihamaki T, Harkonen M, Samloff IM, Siurala M. Gastric morphology, function, and immunology in first-degree relatives of probands with pernicious anemia and controls. Scand J Gastroent 1979; 14: 129–139.
Fukuchi S, Yamada N, Murashiba Y, Yamasaki Y, Nishikage S, Hara M, Tochizuki T Gastric mucosal lesion and gastrin secretion in pernicious anemia. I to Cho (Stomach and Intestine) 1980; 15: 187–199. (English Abst.)
Morson BC, Sobin LH, Grundmann E, Johansen E, Nagayo T, Serck-Hanssen A. Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol 1980; 33: 711–721.
Nakahara K. Special features of intestinal metaplasia and its relation to early gastric carcinoma in man; observation by a method in which leucine aminopeptidase activity is used. J Natl Cancer Inst 1978; 61: 693–702.
Iwabuchi M, Watanabe H, Itsuno M, Narizawa R. Intestinal metaplasia and atrophy of the gastric mucosa—its relation with gastric carcinoma— (Authors's translation). Rinsho Kagaku (Clinical Science) 1985; 21: 87–94. (in Japanese)
Morson BC, Dawson IMP. Gastrointestinal pathology 2nd ed. Oxford: Blackwell Scientific Publications 1979; 150–151.
Matsukura N, Suzuki K, Kawachi T, Aoyagi M, Sugimura T, Kitaoka H, Numajiri H, Shirota A, Itabashi M, Hirota Y. Distribution of marker enzymes and mucin in intestinal metaplasia in human stomach and relation of complete and incomplete types of intestinal metaplasia to minute gastric carcinomas. J Natl Cancer Inst 1980; 65: 231–240.
Iida F, Kusama J. Gastric carcinoma and intestinal metaplasia, significance of types of intestinal metaplasia upon development of gastric carcinoma. Cancer 1982; 50: 2854–2858.
Jass JR. Role of intestinal metaplasia in the histogenesis of gastric carcinoma. J Clin Pathol 1980; 33: 801–810.
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Hirono, M., Mandai, K., Toge, T. et al. Intestinal metaplasia of the stomach confined to the fundic gland area. Report of two cases. The Japanese Journal of Surgery 17, 276–280 (1987). https://doi.org/10.1007/BF02470700
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DOI: https://doi.org/10.1007/BF02470700