Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor: A case report
Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor: A case report
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DOI：
10.3748/wjg.v21.i16.5099
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发表时间：
2015-04-28
影响因子：
4.3
通讯作者：
Kim, Youn-Wha
中科院分区：
文献类型：
--
作者：
Lee, Tae-In;Jang, Jae-Young;Kim, Youn-Wha
胃腺癌是全世界最常见的恶性肿瘤之一。组织化学和免疫组织学分析根据不同的临床和病理特征将胃腺癌的表型分为几组。最近发现了一种新的、罕见的具有主细胞分化的胃腺癌变体（GA-CCD）。由于 GA-CCD 的良性性质，报告独特临床病理特征的研究提出了泌酸腺息肉/腺瘤这一术语。通常，GA-CCD 是在贲门或胃底发生的孤立性粘膜病变。从组织学上看，这种病变的特点是腺体紧密聚集，主细胞呈吻合索。免疫组织化学显示，GA-CCD 粘蛋白 (MUC) 6 呈弥漫性阳性，而 MUC2 和 MUC5AC 呈阴性。然而，其他胃肿瘤如胃神经内分泌肿瘤或胃底腺息肉很难排除。由于GA-CCD在内镜下容易误诊为神经内分泌肿瘤或胃底腺息肉，强烈建议内镜医师进行全面评估和观察。在此，我们报告一例罕见的内镜下类似胃神经内分泌肿瘤的泌酸腺腺瘤病例，并通过内镜下粘膜切除术成功切除。
Gastric adenocarcinoma is one of the most common malignancies worldwide. Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features. A new and rare variant of gastric adenocarcinoma with chief cell differentiation (GA-CCD) has recently been recognized. Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GA-CCD. Typically, GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus. Histologically, this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells. Immunohistochemically, GA-CCD is diffusely positive for mucin (MUC) 6 and negative for MUC2 and MUC5AC. However, other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude. Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp, comprehensive assessment and observation by an endoscopist are strongly recommended. Herein, we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.