Two Cases of Multifocal Gastric Carcinoid with Different Pathogenesis

Ken Kondo¹⁾, Tatsuaki Nakasio, Yasuhisa Yokoyama²⁾, Isao Yokoyama²⁾, Manabu Kikuchi²⁾, Yasushi Kasai, Seiji Akiyama, Katsuki Ito, Hiroshi Takagi

Department of Surgery II, Nagoya University School of Medicine
¹⁾Department of Surgery, Toyohashi National Hospital
²⁾Yokoyama Gastrointestinal Hospital

Two cases of multifocal gastric carcinoid with and without type A gastritis are reported. A 49-year-old man was admitted for further evaluation of the stomach after endoscopic polypectomy of a carcinoid tumor. Marked hypergastrinemia (2200 pg/ml) was observed. Total gastrectomy was performed and the resected specimen showed no obvious elevated lesion. But microscopically, pronounced atropy of the fundic glands (Type A gastritis) and multiple foci of carcinoids in the deeper layer of the propria mucosa to the submucosa were observed. The serum gastrin level returned to normal after the opearation. A 56-year-old man was admitted for treatment of an elevated lesion in the gastric body which was diagnosed as carcinoid. Wedge resection was performed and the specimen showed a main carcinoid lesion and a microcarcinoid. Total gastrectomy was performed 21 months after the first operation. Microscopically, multifocal carcinoid was observed but atrophy of the fundic gland was mild. These findings suggested that multifocal gastric carcinoid developed from type A gastritis or an other type gastritis.

Key words
multifocal gastric carcinoid, type A gastritis, gastrectomy

Reprint requests
Ken Kondo Department of Surgery Toyohashi National Hospital
100 Nakahara, Nakanocho, Toyohashi, 441 JAPAN

Accepted
October 9, 1996

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