A CASE OF EARLY GASTRIC CANCER WITH PERNICIOUS ANEMIA

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A 65 Year-old man visited our hospital with complaints of general fatigue and shortness of breath. Laboratory findings showed severe macrocytic anemia: RBC192, Hb 6.9 g/dl, Ht 21.4%, MCV 111.5 fl, MCH 35.9 pg, MCHC 32.2 g/dl. The intrinsic factor antibody and parietal cell antibody were positive, we made a diagnosis of pernicious anemia. The endoscopic findings showed severe atrophic change of the gastric mucosa, and a small polypoid lesion was detected in the anterior wall of the antrum. The biopsy specimen showed a well-differentiated tubular adenocarcinoma. An endoscopic polypectomy was made. The lesion was 13mm in diamete. Histologically, adenomatous glands were predominant and foci of the well-differentiated tubular adenocarcinoma were observed in the surface layer. Early polypoid gastric cancer appeared in a patient with pernicious anemia, Endoscopic follow-up is thought to be very important, because pernicious anemia is a higher risk factor for gastric cancer.
社団法人日本消化器内視鏡学会の論文