Abstract
Introduction: The pathologic feature of gastric eosinophilic granuloma is eosinophil cells infiltrated into the muscular and submucous layer of the stomach. We reported a rare case of eosinophilic granuloma of mimicking gastric cancer. Case report: A-48-year old man was referred to the department of surgical oncology with epigastric discomfort, vomiting and general fatigue for five years. Gastrofiberscope showed an ulcer lesion in the middle and posterior wall of the gastric body, and a circumferential ulcer lesion of the antrum, the lumen was narrowed, and the mirror could not pass. Pathology report of the section was in favor of infiltration with abundant eosinophils and intestinal metaplasia. Permanent pathology was confirmed with immunohistochemical staining, which demonstrated immune-reactivity for vimentin. In consideration of pyloric obstruction and multiple ulcers, an operation scheme of total gastrectomy was formulated by multiple disciplinary team. Postoperative immunohistochemical staining demonstrated immune-reactivity for vimentin and S-100, which established the final diagnosis for GEG. Discussion and Conclusion: A rare case of gastric eosinophilic granumola with three focus distributed at gastric fundus, body and antrum was described. Total gastrectomy was chosen due to three focus and the prognosis was favorable.
Highlights
The pathologic feature of gastric eosinophilic granuloma is eosinophil cells infiltrated into the muscular and submucous layer of the stomach
Gastric eosinophilic granuloma (GEG) is a rare disease with eosinophil cells infiltrated into mucosal and submucosa of the stomach [1]
We reported a rare case of eosinophilic granuloma of the stomach mimicking gastric cancer
Summary
Gastric eosinophilic granuloma (GEG) is a rare disease with eosinophil cells infiltrated into mucosal and submucosa of the stomach [1]. We reported a rare case of eosinophilic granuloma of the stomach mimicking gastric cancer. Pathology report of the section was in favor of infiltration with abundant eosinophils and intestinal metaplasia. Permanent pathology was confirmed with immunohistochemical staining, which demonstrated immune-reactivity for vimentin. In May 2017, hormone therapy was suspended due to antral perforation, which was cured by conservative medical management. The operation proceeds smoothly, and gross specimen had three shallow ulcers distributed at gastric fundus, body and antrum (Figure 1). Postoperative pathology found eosinophil aggregation in laminae propria and granulation tissue with infiltration of lymphocytes and plasmocytes (Figure 2). No.2:69 demonstrated immune-reactivity for vimentin and S-100, which established the final diagnosis for GEG (Figure 3) Vol. No.2:69 demonstrated immune-reactivity for vimentin and S-100, which established the final diagnosis for GEG (Figure 3)
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