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Abstract：
A 70-year-old man underwent endoscopy, which revealed a slightly depressed and elevated gastric cancer with suspected submucosal invasion of the mid gastric body. Biopsy specimens revealed differentiated tubular adenocarcinoma. We also detected lung and esophageal cancer and prioritized treatment of these lesions, and the patient underwent three endoscopies to monitor changes in gastric cancer. The tumor size and color remained unchanged; however, the marginal ridge was prominent, and the depressed area was deeper on subsequent evaluation. Total gastrectomy was performed 9 months after the first endoscopy. Histopathological examination of the resected specimens showed muscularis propria invasion, well-differentiated tubular adenocarcinoma involving the superficial mucosa, and tumor cells showing clear cytoplasm and a columnar or three-dimensional structure, between the deep mucosa and submucosa. The cells were immunopositive for Sal-like protein 4 and glypican 3; therefore, the patient was diagnosed with gastric adenocarcinoma with enteroblastic differentiation (GAED). This rare gastric cancer variant constituted approximately 70% of the entire lesion, and we observed significant lymphovascular invasion and lymph node metastasis. GAED is a rare histopathological subtype of gastric cancer described in recent years. Few cases of this tumor are reported to date; therefore, our study significantly contributes to the literature.
摘要：
一名70岁的男子接受了内窥镜检查，显示胃癌轻度抑制和升高，怀疑胃中体粘膜下浸润。活检标本显示分化型管状腺癌。我们还检测到肺癌和食道癌，并优先治疗这些病变，患者接受了三次胃镜检查以监测胃癌的变化。肿瘤大小和颜色保持不变；然而，边缘山脊突出，在随后的评估中，凹陷区域更深。首次内镜检查后9个月进行全胃切除术。切除标本的组织病理学检查显示固有肌层侵入，高分化管状腺癌累及浅表粘膜，和肿瘤细胞显示清晰的细胞质和柱状或三维结构，在深层粘膜和粘膜下层之间。细胞对Sal样蛋白4和磷脂酰肌醇蛋白聚糖3免疫阳性；因此，患者被诊断为胃腺癌伴肠母细胞分化(GAED).这种罕见的胃癌变异体约占整个病变的70%，我们观察到明显的淋巴管浸润和淋巴结转移。GAED是最近几年来发明的一种罕见的胃癌组织病理学亚型。迄今为止，很少有这种肿瘤的报道；因此，我们的研究对文献有很大的贡献。
