Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2016; 22(40): 9028-9034
Published online Oct 28, 2016. doi: 10.3748/wjg.v22.i40.9028
Two cases of adenocarcinoma occurring in sporadic fundic gland polyps observed by magnifying endoscopy with narrow band imaging
Kazumi Togo, Tetsuya Ueo, Hirotoshi Yonemasu, Hideho Honda, Tetsuya Ishida, Hiroshi Tanabe, Kenshi Yao, Akinori Iwashita, Kazunari Murakami
Kazumi Togo, Tetsuya Ueo, Hideho Honda, Tetsuya Ishida, Departments of Gastroenterology, Oita Red Cross Hospital, Oita 870-0033, Japan
Hirotoshi Yonemasu, Departments of Pathology, Oita Red Cross Hospital, Oita 870-0033, Japan
Hiroshi Tanabe, Akinori Iwashita, Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino 818-0067, Japan
Kenshi Yao, Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino 818-0067, Japan
Kazunari Murakami, Department of Gastroenterology, Faculty of Medicine, Oita University, Yuhu 879-5503, Japan
Author contributions: Togo K and Ueo T designed and wrote the paper; Togo K, Ueo T and Honda H analyzed the data and treated the patient; Yonemasu H, Tanabe H and Iwashita A made pathological diagnosis; Ishida T and Murakami K made critical revision of the article for important intellectual content; Yao K advised for endoscopic findings.
Institutional review board statement: Oita Red Cross Hospital Institutional Review Board dose not require approval for case reports.
Informed consent statement: The patients involved in this case report authorized the disclosure of their protected health information for academic purposes.
Conflict-of-interest statement: All authors indicate that they have no financial interests or potential conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tetsuya Ueo, MD, PhD, Department of Gastroenterology, Oita Red Cross Hospital, 3 Chome-2-37 Chiyomachi, Oita, Oita Prefecture 870-0033, Japan. ueo14@athena.ocn.ne.jp
Telephone: +81-97-5326181 Fax: +81-97-5331207
Received: July 11, 2016
Peer-review started: July 13, 2016
First decision: August 8, 2016
Revised: August 22, 2016
Accepted: September 12, 2016
Article in press: September 12, 2016
Published online: October 28, 2016
Processing time: 106 Days and 22.6 Hours
Abstract

Gastric fundic gland polyps (FGPs) are common non-adenomatous gastric polyps arising from normal fundic mucosa without Helicobacter pylori (H. pylori) infection. Although systemic FGPs associated with familial adenomatous polyposis (FAP) often have dysplasia, there are few reports of dysplasia occurring in sporadic FGPs, especially when detected by magnifying endoscopy with narrow band imaging (ME-NBI). We experienced two cases of adenocarcinoma occurring in sporadic FGPs, and their ME-NBI findings were very useful for differentiating FGP with cancer from non-dysplastic FGP. A 68-year-old man and a 63-year-old woman were referred to our institution for medical checkup. H. pylori was negative in both patients. Endoscopic examination revealed a small reddish polypoid lesion on the anterior wall of the upper gastric body and several FGPs. ME-NBI showed an irregular microvascular architecture composed of closed loop- or open loop-type vascular components, plus an irregular microsurface structure composed of oval-type surface components which was different from that of FGPs. FAP was denied because of the absence of colon polyps and no familial history of FAP. Pathological diagnosis was adenocarcinoma occurring in sporadic FGP.

Keywords: Sporadic type; Adenocarcinoma; Magnifying endoscopy with narrow band imaging; Adenocarcinoma without Helicobacter pylori infection; Fundic gland polyp

Core tip: Gastric fundic gland polyps (FGPs) are common non-adenomatous gastric polyps arising from normal fundic mucosa without Helicobacter pylori infection. Although systemic FGPs associated with familial adenomatous polyposis often have dysplasia, there are few reports of dysplasia occurring in sporadic FGPs, especially when detected by magnifying endoscopy with narrow band imaging (ME-NBI). We experienced two cases of adenocarcinoma occurring in sporadic FGPs. ME-NBI showed an irregular microvascular architecture plus an irregular microsurface structure which was different from that of FGPs. ME-NBI findings were very useful for differentiating FGP with cancer from non-dysplastic FGP.