Case of early gastric cancer with nodular gastritis

Abstract

A case of depressed early gastric cancer with nodular gastritis is described. A 47-year-old Japanese man was referred to our hospital and admitted for surgical treatment of gastric cancer. Barium upper gastrointestinal study and endoscopy examination showed a 4.5 × 3.0 cm depressed lesion with a deep central ulceration in the anterior wall of the lower corpus. An unusual miliary pattern resembling 'goose flesh' was observed endoscopically in the antrum. Biopsy specimens from the tumor showed poorly differentiated adenocarcinoma, and specimens from the antrum showed many lymphoid follicles with a germinal center. Immunoglobulin G antibody and histological tests (Giemsa stain) for Helicobacter pylori were both positive. Early gastric cancer with nodular gastritis was diagnosed and a subtotal gastrectomy was performed. Histological examination of the resected specimen showed a stage I tumor infiltrating a poorly differentiated adenocarcinoma with a depressed lesion in the corpus (type 0 IIc + III) and nodular gastritis in the antrum. The patient is doing well 1 year after surgery.

Nodular gastritis in association with gastric cancer development before and after Helicobacter pylori eradication

“…In this study, six (5%) cases of gastric cancers, all of which were of the diffuse type, were observed in patients with NG. Previous reports indicate that NG is a risk factor for the development of diffuse‐type gastric cancer in the gastric corpus, and our results were in line with those of previous reports. NG appears to increase the risk of developing diffuse‐type cancer due to highly active gastric inflammation and lower levels of atrophy.…”

“…Observational studies of Japanese adults with NG have suggested an association with gastric cancer, particularly diffuse‐type gastric cancer . However, the biological and epidemiological associations between NG and cancer development are largely unknown.…”

Nodular Gastritis and Gastric Cancer

“…Even though a close relationship between nodular gastritis and duodenal ulcer is reported, 7 a relationship between nodular gastritis with H. pylori infection and gastric cancer has been previously reported only by Miyamoto et al 13 . and Kamada et al 14 . In their reports, 13,14 six cases of gastric cancer with nodular gastritis showed the same characteristics: all gastric cancers were diagnosed histologically as the diffuse‐type and were located in the corpus with H. pylori infection (Figs 3,4).…”

“…The histological features of nodular gastritis are hyperplasia of lymphoid follicles with germinal centers in the proper lamina of the stomach 2,3 . Since the discovery of Helicobacter pylori ( H. pylori ), several studies have shown nodular gastritis to be strongly associated with H. pylori infection, not only in children 2–11 but also in adults 11–15 …”

Advanced gastric cancer associated with nodular gastritis in a young patient

“…This is based on findings from 39 previous reports based on a PubMed search using the key words ''nodular gastritis'' and ''gastric cancer'' for articles published between 1966 and 2008, and ''Torihada-ien'' and ''Igan'' in the Igakuchuo Zasshi for published article in Japanese between 1983 and 2008 (Table 1) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The mean age of the patients was 34.1 years.…”