A CASE REPORT OF MULTIPLE GASTRIC CARCINOIDS ASSOCIATED WITH PERNICIOUS ANEMIA

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  • 悪性貧血に伴った胃カルチノイドの1例

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Gastric carcinoids associating with pernicious anemia are rare and only six cases have been reported in the Japanese literature so far. Recently, a 65-year-old man was admitted to the hospital for further examination of hepatic damage and anemia. After he was diagnosed as pernicious anemia, endoscopic examination revealed multiple polyps of the stomach. Histologically, cacinoid cells were seen in one of the polyps. No symptoms of carcinoid syndrome were observed. Laboratory findings showed megaloblastic anemia, high level of LDH 1, low level of vitamin B12, hypergastrinemia, antibodies of antiparietal cells and antiinterinsic factor, achlorhydria, and myelodysplasia in the bone marrow. A total gastrectomy with lymph node dissection was performed. Tumor cells stained by grimelius stain, EGC, and chromogranin A stain grew with nest formation under the lamina propria and submucosa. There was nob lymph node metastasis. The increased gastrin level fell into normal range after the operation. This case suggests a possible participation of hypergastrimenia in the development of gastric carcinoid. It is also an interesting case today when proton pump inhibitor is being used.

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