Gastritis cystica profunda: a clinicopathologic analysis of 16 cases

GOU Xiang-nan; WANG Feng-hua; ZHAO Po

doi:10.3969/j.issn.1007-8096.2018.06.002

Abstract：Objective To study the clinical symptoms, gastroscopic presentation and pathological characteristics of gastritis cystica profund (GCP) as well as its possible differential diagnosis. Methods We investigated the clinical history and histopathological changes in 16 cases of GCP, with review of related literatures. Results Among the 16 cases, GCP were more commonly found in men than in women, and the overall mean age was 60.4 years. The most common anatomic location of GCP was the gastric fundus (37.5％). The patients in this study had no history of gastric surgery and specific symptoms. Gastroscopy cannot make a diagnosis of GCP. The presence of gastric glands was mainly noted in the submucosa of stomach, and could also deeply extend into muscular layer. In addition to the typical pathogical characteristics of GCP, there were 11 cases with different degrees of dysplasia within superficial mucosa, including 2 cases with low grade lesion, 4 cases with high grade lesion, and 5 cases with carcinoma. There were 5 cases of dysplasia in the deep glands, including 2 cases with low grade lesion, 2 cases with high grade, all with high grade dysplasia within superficial mucosa. All but one case resected by forceps were managed with definite surgical resection or endoscopic mucosal resection (EMR)/ endoscopic submucosal dissection (ESD). When complete excision was performed, there was no recurrences. Conclusions The clinical symptoms and gastroscopic observation of GCP are not typical. Endoscopic ultrasonography combined with EMR or ESD is beneficial to the diagnosis of diseases. None of the 16 patients in this cohort has a history of gastric surgery, which is inconsistent with previous reports. Further studies may help to elucidate the natural history of process and the possibility for malignant potential of GCP.