Whitish gastric mucosa on upper gastrointestinal endoscopy.

Clin Endosc

Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.

Published: March 2024

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984734PMC
http://dx.doi.org/10.5946/ce.2024.016DOI Listing

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Case Summary: A 40-year-old woman presented to the West China Hospital for examination, which revealed a whitish, shallow, and uneven mucosal lesion in the stomach.

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  • A 75-year-old woman was diagnosed with early-stage gastric cancer during an endoscopic examination, specifically a type 0-I carcinoma located on the middle part of her stomach.
  • During the procedure, small whitish structures called white globe appearances (WGAs) were observed near the cancer area, indicating potential subepithelial cancer spread despite the surface appearing flat and noncancerous.
  • Histopathology results confirmed the presence of cancer with significant lymphatic invasion, showing that the cancer had spread along the lymphatic vessels into surrounding tissues, which was likely responsible for the WGA characteristics seen during the endoscopy.
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Article Synopsis
  • The lesion identified during gastroscopy showed specific micro-structural characteristics, leading to a diagnosis of gastric adenocarcinoma with enteroblastic differentiation, categorized as early-stage.
  • Despite recommendations for additional surgery to minimize lymph node metastasis risk, the patient and family declined further intervention, and 14 months post-treatment, the patient remains free of recurrence and is doing well.
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Correlation between White Globe Appearance and Clinicopathologic Characteristics in Early Gastric Cancer.

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