PMC6174740_01
Endoscopic findings. (a) Endoscopic appearance of the sessile gastric HP. (b) Magnifying endoscopy with FICE of the polyp. (c) EMR with lateral safety margins. (d) Endoscopic finding after en bloc resection.
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fig1
Endoscopic examination of the upper digestive tract revealed extensive atrophic gastritis and a sessile lesion of 15 mm of reddish coloration in the distal gastric body (Figure 1(a)). Enhancement (FICE) of the polyp showed an irregular microsurface pattern at the apex, noticing a demarcating line, highly suggestive changes of malignancy (Figure 1(b)). Endoscopic mucosal resection (EMR) was performed with lateral safety margins (Figures 1(c) and 1(d)).
Pathologic findings. (A) Adenomatous change in the background of hyperplastic polyp (H&E, x12.5). (B) Foci of carcinomatous transformation in the adenomatous lesion (H&E,x40).
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fig2
The histopathological evaluation of the resected polyp revealed that the base corresponded to a hyperplastic polyp, in which a tubular adenoma with high-grade dysplasia was established with focal well-differentiated intramucosal tubular adenocarcinoma (Figure 2).