Year 2024 / Volume 116 / Number 8
Digestive Diseases Image
The role of magnification endoscopy in the early diagnosis of gastric signet ring cell carcinoma

442-443

DOI: 10.17235/reed.2023.9364/2022

César Gómez Díez, Pablo Miles Wolfe García, Laura García Alles, Álvaro Terán Lantarón,

Abstract
We present the case of a 67-year-old woman referred to our outpatient clinic presenting dyspepsia. Gastroscopy was performed, showing antral gastritis. Random biopsies were taken, being positive for poorly differentiated Lauren's diffuse gastric adenocarcinoma. Narrow-band imaging gastroscopy was performed, combining random and targeted biopsies, with negative results. The study was completed with echoendoscopy and thoraco-abdominal-pelvic CT scan, showing no relevant pathological findings. Control endoscopic was performed after 12 months, showing no macroscopic lesions. Random biopsies were repeated, being positive for diffuse gastric adenocarcinoma. Gastroscopy with conventional chromoendoscopy was performed, showing a completely flat area of approximately 2cm of diameter in the body-antrum junction, in the greater curvature; it was well delimited and no indigo carmine staining was observed (Figure 1). Electronic magnification was performed, showing disruption of the crypt pattern and aberrant neovessels (Figures 2 and 3). Targeted biopsies were taken, being positive for poorly differentiated gastric adenocarcinoma. The case was discussed in a multidisciplinary session and subtotal gastrectomy was performed. Magnification endoscopy offers a better performance diagnosing early gastric cancer than white light endoscopy. [1] It allows the identification of patterns that can predict malignancy, such as distortion of the mucosal glandular pattern or aberrant proliferation of neovessels. [2] Once the diagnosis has been established, assessing the depth of invasion has great clinical relevance, as it guides therapeutic decisions. Works such as that of Zhou et al. [3] underline the usefulness of linear echoendoscopy in this process.
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References
Kato M, Kaise M, Yonezawa J, et al. Magnifying endoscopy with narrow-band imaging achieves superior accuracy in the differential diagnosis of superficial gastric lesions identified with white-light endoscopy: a prospective study. Gastrointest Endosc 2010;72:523–9.
[2] Tahiri H. et al. Routine endoscopy using a magnifying endoscope for gastric cancer diagnosis. Endoscopy. 2002 Oct;34(10):772-7. doi: 10.1055/s-2002-34267.
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Gómez Díez C, Wolfe García P, García Alles L, Terán Lantarón Á. The role of magnification endoscopy in the early diagnosis of gastric signet ring cell carcinoma. 9364/2022


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Publication history

Received: 16/11/2022

Accepted: 01/01/2023

Online First: 31/01/2023

Published: 01/08/2024

Article Online First time: 76 days

Article editing time: 624 days


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