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Case Reports
. 2022 Mar 22;10(3):e05640.
doi: 10.1002/ccr3.5640. eCollection 2022 Mar.

Mixed neuroendocrine-non-neuroendocrine neoplasm associated with autoimmune gastritis

Naoko Mori  1 , Masanori Hongo  1 , Shizuki Takemura  2 , Yoshihiko Sugitani  1 , Fumiyasu Nakamura  1 , Masaji Tani  3 , Atsushi Nishida  4 , Osamu Inatomi  4 , Akira Andoh  4 , Hiromitsu Ban  1
Affiliations
Case Reports

Mixed neuroendocrine-non-neuroendocrine neoplasm associated with autoimmune gastritis

Naoko Mori et al. Clin Case Rep. .

Abstract

A 60-year-old woman presented with a protruding tumor at the anterior wall of the middle gastric body, and she was positive for anti-parietal cells antibodies with elevated serum gastrin level. Final diagnosis was a mixed neuroendocrine-non-neuroendocrine neoplasm consisting of adenocarcinoma (tub1) and neuroendocrine tumor G2 with autoimmune gastritis.

Keywords: adenocarcinoma; autoimmune gastritis; endoscopic submucosal dissection; mixed neuroendocrine‐non‐neuroendocrine neoplasms.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

FIGURE 1
FIGURE 1
Endoscopic findings of gastric mixed neuroendocrine‐non‐endocrine neoplasm with autoimmune gastritis. (A) Esophagogastroduodenoscopy (EGD) revealed a normal mucosa of the gastric antrum. (B) EGD revealed a marked mucosal atrophy of the gastric body. (C and D) EGD showed an approximately 10‐mm protruding tumor with slight redness at the anterior wall of the middle gastric body. Several small polypoid lesions were also detected. (E) Magnified endoscopy with narrow‐band imaging showed a normal pit pattern with a scar from a previous biopsy at the former clinic. There were some bumps on the surface of the tumor. (F) Endoscopic ultrasound image shows a mass consisting of low‐ and heteroechoic lesions raised from the second and the third layer of gastric wall. The deep part of the third layer was intact
FIGURE 2
FIGURE 2
Histological findings of the resected sample by endoscopic submucosal dissection. (A) The tumor was a 10 × 12‐mm submucosal tumor consisting of two components with a fibrotic change and dilated cystic structures. (B, C and D) One component was a glandular structure with irregularly shaped ducts (yellow arrow heads), and this was diagnosed as well‐differentiated tubular adenocarcinoma (tub1). The other component was composed of small‐to‐large round cells with hyperchromatic nuclei forming solid nests (black arrow heads), suggesting a neuroendocrine neoplasm. Original magnification: A ×20, B ×40, C ×100, D ×400
FIGURE 3
FIGURE 3
Immunohistochemical staining of the tumor. The cells of neuroendocrine components were positive for neuroendocrine markers such as chromogranin A, synaptophysin, and somatostatin receptors 2 (SSTR2), and the Ki67 proliferation index was 3.8%. These cells were negative for p53 staining
See this image and copyright information in PMC

References

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