White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer

A 75-year-old female was diagnosed with a type 0-I, moderately differentiated, early gastric carcinoma on the posterior wall of the middle gastric body during esophagogastroduodenoscopy (EGD). Several small whitish structures, referred to as white globe appearances (WGAs), were noted on the oral sid...

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Main Authors: Hiroki Maruyama, Taku Yamagata, Yoshihide Kanno, Takeshi Shimizu, Takuho Itasaka, Fumiyoshi Fujishima, Takashi Sawai, Kei Ito
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2024/8504987
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author Hiroki Maruyama
Taku Yamagata
Yoshihide Kanno
Takeshi Shimizu
Takuho Itasaka
Fumiyoshi Fujishima
Takashi Sawai
Kei Ito
author_facet Hiroki Maruyama
Taku Yamagata
Yoshihide Kanno
Takeshi Shimizu
Takuho Itasaka
Fumiyoshi Fujishima
Takashi Sawai
Kei Ito
author_sort Hiroki Maruyama
collection DOAJ
description A 75-year-old female was diagnosed with a type 0-I, moderately differentiated, early gastric carcinoma on the posterior wall of the middle gastric body during esophagogastroduodenoscopy (EGD). Several small whitish structures, referred to as white globe appearances (WGAs), were noted on the oral side outside the demarcation line of the cancerous protrusion. Although this area was flat without cancerous mucosal changes on the surface, subepithelial cancer extension was suspected. The histopathology of the resected specimen revealed that the carcinoma with submucosal invasion had significant lymphatic invasion with submucosal lateral extent along lymphatic vessels. In some areas, the carcinoma within the lymphatic vessels regressed from the submucosal layer towards the mucosal lamina propria, penetrating the muscularis mucosas. The intralymphatic carcinoma reaching just beneath the epithelium was considered to manifest WGA features during endoscopy.
format Article
id doaj-art-d09ba32a0ae5480fbc613d8da1d2878f
institution OA Journals
issn 2090-6536
language English
publishDate 2024-01-01
publisher Wiley
record_format Article
series Case Reports in Gastrointestinal Medicine
spelling doaj-art-d09ba32a0ae5480fbc613d8da1d2878f2025-08-20T02:20:05ZengWileyCase Reports in Gastrointestinal Medicine2090-65362024-01-01202410.1155/2024/8504987White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric CancerHiroki Maruyama0Taku Yamagata1Yoshihide Kanno2Takeshi Shimizu3Takuho Itasaka4Fumiyoshi Fujishima5Takashi Sawai6Kei Ito7Department of GastroenterologyDepartment of GastroenterologyDepartment of GastroenterologyDepartment of GastroenterologyDepartment of GastroenterologyDepartment of PathologyDepartment of PathologyDepartment of GastroenterologyA 75-year-old female was diagnosed with a type 0-I, moderately differentiated, early gastric carcinoma on the posterior wall of the middle gastric body during esophagogastroduodenoscopy (EGD). Several small whitish structures, referred to as white globe appearances (WGAs), were noted on the oral side outside the demarcation line of the cancerous protrusion. Although this area was flat without cancerous mucosal changes on the surface, subepithelial cancer extension was suspected. The histopathology of the resected specimen revealed that the carcinoma with submucosal invasion had significant lymphatic invasion with submucosal lateral extent along lymphatic vessels. In some areas, the carcinoma within the lymphatic vessels regressed from the submucosal layer towards the mucosal lamina propria, penetrating the muscularis mucosas. The intralymphatic carcinoma reaching just beneath the epithelium was considered to manifest WGA features during endoscopy.http://dx.doi.org/10.1155/2024/8504987
spellingShingle Hiroki Maruyama
Taku Yamagata
Yoshihide Kanno
Takeshi Shimizu
Takuho Itasaka
Fumiyoshi Fujishima
Takashi Sawai
Kei Ito
White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
Case Reports in Gastrointestinal Medicine
title White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
title_full White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
title_fullStr White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
title_full_unstemmed White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
title_short White Globe Appearance–Like Findings Indicating Intralymphatic Cancer Involvement Beneath the Epithelium in Gastric Cancer
title_sort white globe appearance like findings indicating intralymphatic cancer involvement beneath the epithelium in gastric cancer
url http://dx.doi.org/10.1155/2024/8504987
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