Keishi Takechi

Gastric Pit Density and Depth of Foveolae of the Gastric Body Mucosa Assessed by Dye Endoscopy

Abstract: We examined the histological characteristics of the foveolar zone of the gastric body mucosa, using dye endoscopy and endoscopic biopsy. In 63 patients, the gastric area type of the gastric body was placed in one of the following categories; fundic gland type 0 (F0), where small and fine areas are arranged closely to one another; F1, where the areas are largest in size, round and high; F2, where the areas are intemediate in size but not so high; F3, where small and flat areas are loosely arranged; pseudo‐pyloric gland type 1 (Pb1), where the areas are regular in size and arrangement; and the completely atrophic gland type (Pb2) with areas irregular in size and arrangement. The histological characteristics of the foveolar zone were emmined on printed microphotographs of the biopsy specimens of the gastric body. The density of the gastric pit was defined as the number of pits in a 1 mm width of the mucosal surface and depth of the foveolae was measured as the distance between the top and bottom (or the isthmus) of the foveolae as seen on vertical sections. The gastric pit density and depth of the foveolae were dense and shallow, respectively, in FO and sparse and deep, in Pbl and Pb2 respectively. The degree of these factors showed independency in area types F0, F1 and Pb2 and there were correlations of P<0.033 and P<0.001 between F2 and Pb1, F3 and Pb1, respectively.

A Case of Inflammatory Bowel Disease Accompanied by Myasthenia Gravis

Abstract: A 62‐year‐old female visited our unit complaining of persisting diarrhea. She underwent a thymectomy for myasthenia gravis (MG) and a thyroidectomy for malignancy at age 58, and she was treated medically for MG fbllowing surgery. She also received a partial ileo‐colectomy because of an intramural suppurative abscess of the terminal ileum at age 60. In her laboratory data, the anti‐acetylcholine receptor antibody and antinuclear antibody were positive, and IgG as well as IgA were a high titer. X‐ray and endoscopic examinations revealed the presence of stiff and narrow lesions accompanied by longitudinal ulcers of the descending colon, and rough and granular mucosa of the rest of the colon and stomach. An elemental diet was not effective, but her condition was relieved by the oral administration of prednisolone. This case was considered a case of inflammatory bowel disease ac‐companied by MG and systemic immunological disorders.

Early Gastric Lymphoma Coexisting with Reactive Lymphoreticular Hyperplasia (RLH) -A Case Report-

A 34‐year‐old female visited our hospital because of epigastralgia. We performed an upper gastrointestinal x‐ray examination, and both conventional endoscopy and dye‐spraying endoscopy (indigo‐carmine contrast method). We diagnosed early gastric lymphoma which simulated Borrmann 3 type gastric cancer with IIb type early gastric cancer on the middle body and reactive lymphoreticular hyperplasia (RLH) of cobble stone‐like granular pattern by endoscopic appearance on the lower body. Although dye‐spraying endoscopy showed the details of the mucosa, it was very difficult to diagnose the lesions correctly by gross appearance alone. Because gastric lymphoma arises from the mucosal or submucosal layer and spreads in the mucosa diffusely, ultrasonic visualization by echo‐endoscopy might be useful in the diagnostic procedure. We report a case of early gastric lymphoma coexisting with RLH; both lesions showed uncommon endoscopic features.