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http://dx.doi.org/10.5230/jgc.2018.18.e22

Gastric Adenocarcinoma of Fundic Gland Type with Aggressive Transformation and Lymph Node Metastasis: a Case Report  

Okumura, Yasuhiro (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Takamatsu, Manabu (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Ohashi, Manabu (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Yamamoto, Yorimasa (Division of Gastroenterology, Showa University Fujigaoka Hospital)
Yamamoto, Noriko (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Kawachi, Hiroshi (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Ida, Satoshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Kumagai, Koshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Nunobe, Souya (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Hiki, Naoki (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Sano, Takeshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
Publication Information
Journal of Gastric Cancer / v.18, no.4, 2018 , pp. 409-416 More about this Journal
Abstract
A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.
Keywords
Gastric gland; Lymph nodes; Neoplasm metastasis;
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