PMC7265051_01
a. Esophagogastroduodenoscopy revealed a 10 mm submucosal tumor-like lesion in the greater curvature of the upper gastric remnant body five years prior. b. The tumor size grew to 14 mm in the three years prior. c. The tumor size had grown to 16 mm when performing biopsy with no malignancy one year prior. (short arrows) and internal liquid shown (long arrows).
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Because there was no sign of malignancy, the gastric lesion was followed up by annual EGD (Fig. 1).
a, b. Esophagogastroduodenoscopy revealed a delle on the top of the tumor. c. Endoscopic ultrasonography revealed a hypo-echoic tumor located in the third layer (white arrows). d. Biopsy specimen revealed poorly differentiated adenocarcinoma.
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A delle was observed on the top of the tumor five year after the first visit and a biopsy specimen revealed poorly differentiated adenocarcinoma (Fig. 2).
a. The picture shows a resected specimen. The resected tumor was 25 mm in size surrounded by black square. b. Histological assessment revealed a 28 x 22 mm ulcerative protrusion. Adenocarcinoma was detected in part of yellow line. c, d, e. Microscopically, papillary adenocarcinoma (AC: arrow heads) was observed at the submucosa with solitary heterotopic gastric gland (sHGG: dotted line) adjacent to the lesion (hematoxylin-eosin staining, original magnification: x 400). There are smooth muscle tissues (surrounded by the blue line) around the adenocarcinoma and sHGG.
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Microscopically, papillary adenocarcinoma was observed with a solitary heterotopic gastric gland (sHGG) surrounding by smooth muscle tissues (Fig. 3).
Immunohistochemical stainings are shown below.. a. MUC1 was negative. b. MUC2 was negative. c. MUC5AC was positive. d. MUC6 was positive.
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Immunohistochemical staining of sHGG, MUC5AC and MUC6 were positive, and MUC1 and MUC2 were negative (Fig. 4).