Autoimmune gastritis (type A gastritis) is characterized by the presence of hypergastrinemia, a positive test result for anti-parietal cell antibody and macrocytic anemia, and is associated with a high incidence of gastric carcinoid tumor. However, there are only a few reports of gastric cancer associated with autoimmune gastritis. In this case report, we describe a patient with autoimmune gastritis, who presented with psychological symptoms, in whom we performed endoscopic submucosal dissection (ESD) for associated early gastric cancer.
Case : An 88-year-old female was admitted to our hospital because of some psychological symptoms. The laboratory data at admission revealed macrocytic anemia, a low serum level of vitamin B12, and a negative serological test result for anti-parietal cell antibody. Endoscopically, findings of pangastritis were observed, strongly suggestive of autoimmune gastritis. Histopathologically, a biopsy specimen from the stomach confirmed autoimmune gastritis, based on the positive staining result for Chromogranin A. At the same time, the patient was also diagnosed as having early gastric cancer ; therefore, ESD was performed successfully using a dual knife and sodium hyaluronate. Histopathological examination of the resected specimen confirmed well-differentiated adenocarcinoma. There are only a few reports of gastric ESD for gastric cancer associated with autoimmune gastritis.
