Clinical Journal of Gastroenterology

, Volume 11, Issue 2, pp 127–132 | Cite as

A case of a protruded lesion formed by a poorly differentiated intramucosal adenocarcinoma of the stomach: an immunohistochemical analysis

  • Keiichiro Nakajo
  • Yasuhiro Oono
  • Takeshi Kuwata
  • Tomonori Yano
Case Report


A 70-year-old woman underwent upper gastrointestinal endoscopy and was found to have a 25-mm protruded lesion in the gastric body. A biopsy revealed malignant cells. Endoscopic submucosal dissection was performed. Histopathologically, the tumor was mainly composed of poorly differentiated adenocarcinoma (PDA), while moderately differentiated adenocarcinoma was observed on its superficial layer. The tumor was located within the mucosal layer. PDAs rarely form a protruded lesion. Here, the presence of a moderately differentiated adenocarcinoma element in the superficial layer of the tumor might have protected the tumor cells from erosion, and solid proliferation of the PDA also contributed to its outward growth.


Poorly differentiated adenocarcinoma Protruded type Endoscopic submucosal dissection Early gastric cancer 



We thank Dr. Hiroya Ueyama of the Department of Gastroenterology, and Dr. Takashi Yao of the Department of Pathology at the Juntendo University School of Medicine for evaluating the pathological findings.

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Human rights

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

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  • Keiichiro Nakajo
    • 1
  • Yasuhiro Oono
    • 1
  • Takeshi Kuwata
    • 2
  • Tomonori Yano
    • 1
  1. 1.Department of Gastroenterology and EndoscopyNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Division of PathologyNational Cancer Center Hospital EastKashiwaJapan

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