Heterotopic Gastric Glands Research Articles

Subepithelial Tumor-like Gastric Cancer

Subepithelial tumor-like gastric cancer (SET-like GC) is a special type of gastric cancer with a relatively low prevalence of approximately 1%. Diagnosing SET-like GC is challenging because the tumor is often covered with normal mucosa. The mechanisms of occurrence of SET-like GC include: 1) excessive infiltration of lymphocytes in the cancer, 2) intensive secretion of mucin by mucinous adenocarcinoma, 3) excessive fibrosis around the cancer, and 4) adenocarcinoma arising from heterotopic gastric glands in the submucosa. It is important to be aware of the endoscopic features of SET-like GC to differentiate it from other subepithelial tumors, to recognize the possibility of SET-like GC, and to make a diagnosis before treatment. In this review, we summarized the epidemiologic and clinicopathologic characteristics of SET-like GC.

Gastric Adenocarcinoma with Enteroblastic and Neuroendocrine Differentiation Arising near the Heterotopic Gastric Glands and Ectopic Pancreas

Gastric Adenocarcinoma with Enteroblastic and Neuroendocrine Differentiation Arising near the Heterotopic Gastric Glands and Ectopic Pancreas

Gastric adenocarcinoma of fundic gland type arising from heterotopic gastric glands during a 19-year follow-up period

A 73-year-old man with prior history of duodenal ulcer has been undergoing periodic upper gastrointestinal endoscopy since 1999. In 2017, a 25-mm submucosal tumor-like protrusion was detected in the lesser curvature of the upper stomach; histological examination of the lesion revealed gastric adenocarcinoma of fundic gland type. En bloc resection was achieved using endoscopic submucosal dissection. The patient was histopathologically diagnosed with gastric adenocarcinoma of fundic gland type arising from heterotopic gastric glands. Immunohistochemical staining was positive for MUC5AC, MUC6, pepsinogen I, and proton pump but negative for MUC2 and CD10. Moreover, the patient’s Ki-67 labeling index score was extremely low. The presence of MUC5AC indicated that the tumor differentiated to the foveolar epithelium and fundic glands. Gastric adenocarcinoma of fundic gland type that differentiates to several directions has a higher malignant potential than the disease that differentiates to chief cells. A retrospective review of the patient’s previous endoscopic examination revealed that the submucosal tumor-like protrusion existed since 2000; tumor size increased from 8 mm in 2000 to 25 mm in 2017. The present case is rare in that the carcinoma arose from heterotopic gastric glands. Moreover, the 19-year follow-up revealed that the tumor differentiated to the foveolar epithelium, considered as having high-grade malignancy.

Gastric adenocarcinoma of fundic gland type spreading to heterotopic gastric glands

Herein, we present a case of gastric adenocarcinoma of fundic gland type (GA-FG) spreading to heterotopic gastric glands (HGG) in the submucosa. A 58-year-old man with epigastric pain was referred to our hospital and underwent an esophagogastroduodenoscopy. A Borrmann type II gastric cancer at the antrum and a 10 mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach were detected. Histological examination of the biopsy specimens obtained from the submucosal tumor-like lesion suggested a GA-FG. Therefore, endoscopic submucosal dissection was performed as excisional biopsy, and histopathological examination of the resected specimen confirmed a GA-FG and HGG proximal to the GA-FG. Although the GA-FG invaded the submucosal layer slightly, the submucosal lesion of the GA-FG had a poor stromal reaction and was located just above the HGG in the submucosa. Therefore, we finally diagnosed the lesion as a GA-FG invading the submucosal layer by spreading to HGG.

急速に増大した胃粘膜下腫瘍の1例

A sixties woman was found to have a about 25mm gastric submucosal tumor (SMT) on the anterior wall of the antrum on esophagogastroduodenoscopy (EGD) , which had not been observed on EGD one year previously. Endoscopic ultrasonography (EUS) showed that the SMT was a heterogenous and echogenic lesion with an anechoic area and it was mainly located in the third layer. Endoscopic submucosal dissection (ESD) was performed in order to diagnose the tumor. Pathological examination revealed heterotopic gastric glands (HGG) with hyperplastic mucosa. HGG are sometimes accompanied by gastric cancer. Our case was not complicated with gastric cancer. We experienced a case of HGG whose size increased rapidly within one year, in which ESD was performed in order to obtain a diagnosis.

A Case of Multiple Early Gastric Cancer Associated with Diffuse Submucosal Heterotopic Gastric Glands

A Case of Multiple Early Gastric Cancer Associated with Diffuse Submucosal Heterotopic Gastric Glands

A Case of Gastric Collision Cancer Consisting of Poorly Differentiated Adenocarcinoma and Neuroendocrine Carcinoma at Diffuse Submucosal Heterotopic Gastric Glands

A Case of Gastric Collision Cancer Consisting of Poorly Differentiated Adenocarcinoma and Neuroendocrine Carcinoma at Diffuse Submucosal Heterotopic Gastric Glands

びまん性胃粘膜下異所腺に併存した早期胃癌の2例

びまん性胃粘膜下異所腺に併存した早期胃癌の2例

Advanced gastric cancer deriving from submucosal heterotopic gastric glands based on pathological diagnosis

Advanced gastric cancer deriving from submucosal heterotopic gastric glands based on pathological diagnosis

A duplication cyst masquerading as a meckel's diverticulum

Gastrointestinal tract duplication cysts are rare congenital malformations, usually presenting in infancy or early childhood with a variety of symptoms within the GI tract. Sources of GI bleeding can present a diagnostic dilemma despite conventional radiological & endoscopic investigations. We present an unusual case of a 13 year old boy, who presented with an acute abdomen and malaena with contrasting radiological and operative findings. A 13 year old boy was referred to our hospital with a 2 week history of severe central abdominal pain and 2 episodes of malaena. On assessment he appeared well and was haemodynamically stable. On physical examination his abdomen was tender centrally. Digital rectal examination was normal. Blood tests revealed a Haemoglobin of 7.2 with a MCV of 58.3. Abdominal X-ray showed faecal loading. An ultrasound scan of his abdomen found an abnormally dilated fluid-filled loop in the right iliac fossa extending into the pelvis. An MRI scan with Haste sequences was undertaken for additional clarity, and this favoured a Meckel9s appearance. A laparotomy revealed a large 30 cm long cystic lesion in the mesentery of the ileum. The ileum was extremely adherent to this cyst, thus en bloc ileal resection was performed with primary anastomosis. The boy was discharged uneventfully on post-operative day 3. Histology confirmed a congenital duplication cyst with heterotopic gastric glands. This demonstrated an area of haemorrhage subserosally. Alimentary tract duplications are rare childhood anomalies, but may cause intestinal obstruction, intussusception, haemorrhage or perforation. They are most commonly located in the ileum, but can occur anywhere from pharynx to rectum. They are lined by intestinal tract mucosa and share a common smooth muscle wall and blood supply with adjacent bowel wall, with which they can communicate. Malignant change has rarely been reported in adults, in particular within rectal duplication cysts. The duplication cyst attached to this boy9s ileum revealed gastric mucosa, which contains acid-secreting parietal cells resulting in peptic-ulcer type ulceration and bleeding. Intestinal duplication cysts should be considered in the differential diagnosis of GI bleeding in children. Complete excision is the treatment of choice.

Gastritis Cystica Profunda: A Rare Gastric Tumor Masquerading as a Malignancy

Introduction: Gastritis cystica profunda (GCP) is a rare tumor which occurs more commonly in patients with prior gastric surgery. The nonspecific symptoms and radiographic appearance of this tumor mimic that of other hyperproliferative conditions making diagnosis difficult without definitive surgical resection. This report provides a comprehen-sive review of GCP and all GCP cases reported to date. Methods: A comprehensive literature search (1972-2011) was conducted with all reported GCP cases analyzed. Keywords searched included gastritis cystica profunda, submucosal cysts of the stomach, and heterotopic submucosal gastric glands. Results: Thirty-seven GCP cases have been reported since 1972, which includes 29 (78%) men and 8 (21%) women (M:F ratio, 3.6:1). The overall mean age was 60.5 years (range, 39 - 81 years) with 55.6 years (range, 39 - 79) and 62.2 years (range, 39 - 81 years) in women and men, respectively. 65% (N = 24) had prior gastric surgery. 62% (N = 23) of GCP tumors were located in the body; 24% (N = 9) in the fundus; 8% (N = 3) in the antrum; or 6% (N = 2) in the cardia of the stomach. GCP was an incidental finding in 19% of patients. Complete excision was performed most often (73%) followed by endomucosal resection (18%), and polypectomy (4.5%). One patient underwent surveillance (4.5%). Conclusions: GCP is a rare gastric tumor, which is difficult to diagnose preoperatively and masquerades as a malignancy. GCP is more common in men and typically presents with nonspecific symptoms. Although a benign lesion, GCP may represent an intermediate histology in the malignant progression to gastric neoplasia. To date, there have been no reports of local recurrence or distant metastasis following definitive surgical excision, which remains the standard of care.

Gastritis cystica profunda presenting as giant gastric mucosal folds: The role of endoscopic ultrasonography and mucosectomy in the diagnostic work-up

Multiple small cysts in the mucosa and submucosa of the stomach have been rarely encountered. Various terms for these lesions have been proposed, such as gastritis cystica profunda,1 diffuse submucosal cysts of the stomach,2 submucosal heterotopic gastric glands,3 gastritis cystica polyposa,4 and diffuse heterotopic cystic malformation of the stomach.5 These lesions have been found not only at the site of a gastroenterostomy but also in the stomachs of patients without any previous surgery.2,3,6 The diagnostic approach for this disorder depends on the condition of the resected stomach.

Jejunal Adenocarcinoma in Congenital Heterotopic Gastric Mucosa

We describe an adenocarcinoma of the jejunum that developed in congenital heterotopic gastric mucosa, a rare event. In our patient, the absence of other intestinal malformation and the presence of gastric glands with variable grades of dysplasia, together with the histological pattern of the tumor, strongly favor the possible origin of the neoplasia from the heterotopic gastric glands, rather than from intestinal ones.

HETEROTOPIC GASTRIC GLANDS IN THE SUBMUCOSA OF THE STOMACH

The submucosal heterotopic gastric glands were found in 160 cases (10.7%) of 1500 resected stomachs; 15% in gastric ulcer, 9.9% in gastric carcinoma, 4% in duodenal ulcer and 11% in chronic gastritis. The heterotopic glands were usually found in the distal half of the stomach, diffusely or localized. Macroscopic submucosal tumor was found in 9 (5%) of 160 cases. Although the heterotopic glands were found with an intimate relation to the repeated mucosal damage and subsequent intestinal metaplasia, they had no specific relation to gastric carcinogenesis.

Primary adenocarcinoma of the esophagus simulating a benign lesion.

Primary adenocarcinoma of the esophagus is an uncommon finding. In a series of 89 patients with carcinoma of the esophagus recently reported,1there occurred only one primary adenocarcinoma, the remainder of the lesions being squamous cell neoplasms. Garlock,2whose experience with this type of lesion has been considerable, has seen but three primary adenocarcinomas of the esophagus. Adenocarcinoma of the esophagus occurs invariably as a secondary extension of a gastric lesion by contiguous spread from the cardia. When adenocarcinoma of the esophagus is primary, the malignant development takes place in submucosal esophageal glands or in heterotopic gastric glands that may be present in the esophagus. The following report is of a primary adenocarcinoma of the esophagus presenting the appearance of a benign submucosal lesion on x-ray examination. The diagnosis of a malignant neoplasm was made only after histopathological examination of tissue obtained by esophagoscopy. REPORT OF A CASE