A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa

Abstract Background The development of immunohistochemical staining has revealed that gastric adenocarcinoma with the gastric phenotype can be divided into the foveolar, fundic gland, and pyloric gland phenotypes. Gastric adenocarcinoma of the pyloric gland type is difficult to diagnose using biopsy...

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Main Authors: Kaiho Hirata, Shusuke Yagi, Hideki Miyazaki, Kazuhiko Yamada, Naoki Akazawa, Naoki Enomoto, Kyoko Nohara, Chizu Yokoi, Toru Igari, Norihiro Kokudo
Format: Article
Language:English
Published: SpringerOpen 2024-04-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-024-01835-8
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author Kaiho Hirata
Shusuke Yagi
Hideki Miyazaki
Kazuhiko Yamada
Naoki Akazawa
Naoki Enomoto
Kyoko Nohara
Chizu Yokoi
Toru Igari
Norihiro Kokudo
author_facet Kaiho Hirata
Shusuke Yagi
Hideki Miyazaki
Kazuhiko Yamada
Naoki Akazawa
Naoki Enomoto
Kyoko Nohara
Chizu Yokoi
Toru Igari
Norihiro Kokudo
author_sort Kaiho Hirata
collection DOAJ
description Abstract Background The development of immunohistochemical staining has revealed that gastric adenocarcinoma with the gastric phenotype can be divided into the foveolar, fundic gland, and pyloric gland phenotypes. Gastric adenocarcinoma of the pyloric gland type is difficult to diagnose using biopsy because of its low atypia and rarity. Herein, we describe a case of gastric adenocarcinoma of the pyloric gland type that was diagnosed immunohistochemically after endoscopic resection. Case presentation A 67-year-old man was referred to our hospital for the diagnosis and treatment of a 30-mm elevated lesion on the lesser curvature side of the middle of the gastric body. Although four biopsies were performed, it was difficult to determine whether the lesion was benign or malignant. Therefore, endoscopic submucosal dissection was performed, and the presence of tumor cells infiltrating the submucosa with venous invasions was identified. Immunohistochemical staining revealed that the tumor cells were positive for MUC5AC and MUC6 and negative for Pepsinogen I and H + /K + -ATPase. From the above findings, he was diagnosed as having gastric adenocarcinoma with pyloric gland type. The patient underwent a laparoscopic distal gastrectomy and was discharged without any adverse events. Conclusions Gastric adenocarcinoma of the pyloric gland type is a rare disease, and endoscopic resection can serve as a viable diagnostic option for this condition when it is difficult to diagnose using biopsy. Immunohistochemical pathology images can aid in the diagnosis of gastric adenocarcinoma of the pyloric gland type.
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spelling doaj.art-74f869d8b4f0451cad327e3bc1bb2af72024-04-07T11:28:32ZengSpringerOpenSurgical Case Reports2198-77932024-04-011011610.1186/s40792-024-01835-8A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosaKaiho Hirata0Shusuke Yagi1Hideki Miyazaki2Kazuhiko Yamada3Naoki Akazawa4Naoki Enomoto5Kyoko Nohara6Chizu Yokoi7Toru Igari8Norihiro Kokudo9Department of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Pathology, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Gastroenterology, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Gastroenterology, Center Hospital of the National Center for Global Health and MedicineDepartment of Pathology, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineAbstract Background The development of immunohistochemical staining has revealed that gastric adenocarcinoma with the gastric phenotype can be divided into the foveolar, fundic gland, and pyloric gland phenotypes. Gastric adenocarcinoma of the pyloric gland type is difficult to diagnose using biopsy because of its low atypia and rarity. Herein, we describe a case of gastric adenocarcinoma of the pyloric gland type that was diagnosed immunohistochemically after endoscopic resection. Case presentation A 67-year-old man was referred to our hospital for the diagnosis and treatment of a 30-mm elevated lesion on the lesser curvature side of the middle of the gastric body. Although four biopsies were performed, it was difficult to determine whether the lesion was benign or malignant. Therefore, endoscopic submucosal dissection was performed, and the presence of tumor cells infiltrating the submucosa with venous invasions was identified. Immunohistochemical staining revealed that the tumor cells were positive for MUC5AC and MUC6 and negative for Pepsinogen I and H + /K + -ATPase. From the above findings, he was diagnosed as having gastric adenocarcinoma with pyloric gland type. The patient underwent a laparoscopic distal gastrectomy and was discharged without any adverse events. Conclusions Gastric adenocarcinoma of the pyloric gland type is a rare disease, and endoscopic resection can serve as a viable diagnostic option for this condition when it is difficult to diagnose using biopsy. Immunohistochemical pathology images can aid in the diagnosis of gastric adenocarcinoma of the pyloric gland type.https://doi.org/10.1186/s40792-024-01835-8Immunohistochemical stainingGastric cancerGastric adenocarcinoma with pyloric gland type
spellingShingle Kaiho Hirata
Shusuke Yagi
Hideki Miyazaki
Kazuhiko Yamada
Naoki Akazawa
Naoki Enomoto
Kyoko Nohara
Chizu Yokoi
Toru Igari
Norihiro Kokudo
A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
Surgical Case Reports
Immunohistochemical staining
Gastric cancer
Gastric adenocarcinoma with pyloric gland type
title A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
title_full A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
title_fullStr A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
title_full_unstemmed A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
title_short A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
title_sort case of gastric adenocarcinoma with pyloric gland type infiltrating submucosa
topic Immunohistochemical staining
Gastric cancer
Gastric adenocarcinoma with pyloric gland type
url https://doi.org/10.1186/s40792-024-01835-8
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