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Am J Gastroenterol 2024;119:1459. https://doi.org/10.14309/ajg.0000000000002758; published online March 14, 2024
A 49-year-old man underwent esophagogastroduodenoscopy for gastric cancer screening.
A large flat lesion approximately 12 cm in size was seen in the fundus and body of the stomach,with multiple protruded lesions in the center (a). Biopsy of the lesion suggested high-grade dysplasia.
He was diagnosed with autoimmune gastritis, with severe mucosal atrophy restricted in gastric corpus and positive serum antiparietal cell antibody. Groove-type mucosa was observed in magnifying narrow-band imaging of gastric corpus, suggesting superficial spreading type of early gastric cancer in the setting of autoimmune gastritis.
The lesion was successfully resected by endoscopic submucosal dissection and endoscopic piecemeal mucosal resection (b). The resected specimen histopathologically showed an intramucosal papillary carcinoma and moderately to highly differentiated tubular adenocarcinoma with negative margins. There was no lymphovascular invasion. Computer tomography did not show evidence of lymph node or distant metastasis.
The patient received a close follow-up every 6 months with endoscopy and enhanced computer tomography. Gastroscopy after 1 year showed ulcer scarring (c). No recurrence was noted during the 3-year follow-up.