A CASE OF DOUBLE EARLY GASTRIC STUMP CARCINOMA ACCOMPANIED WITH GASTRITIS CYSTICA POLYPOSA (GCP)

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A 63-year-old man who undergone Billroth II gastrectomy due to gastric ulcer 33 years ago was admitted to our hospital in July 1989 because of gastric stump carcinoma associated with gastritis cystica polyposa (GCP). Endoscopic examination revealed a protruded lesion with redness on anastomotic site and small II c-like lesion on the anterior wall. The protruded lesion was gradually shifted to the normal mucosa. The total gastrectomy with resection of the adjacent jejunal portion was carried out. Macroscopically, the resected specimen showed an annular protrusion with more highly elevated portion associated with small IIc-like lesion. Histologically, stomal gastric mucosa showed hyperplasia of foveolar epithelium, pseudopyloric gland metaplasia, cystic dilatation of gland and their submucosal aberration ; these features were compatible with those of gastritis cystica polyposa (GCP) proposed by Litller et al., and double early gastric carcinoma existed in GCP. It was considered that carcinoma develloped from GCP, because these were surrounded by GCP.<BR> Seventeen cases of gastric stump carcinoma associated with GCP were reported in Japan. Average interval of 17 cases was twenty-three years and 15 of 17 cases (88%) had undergone Billroth II anastomotis.
社団法人日本消化器内視鏡学会の論文