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Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case

Patient: Male, 60-year-old Final Diagnosis: Gastric carcinoma Symptoms: Asymptomatic Medication:— Clinical Procedure: Surgical resection Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) i...

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Autores principales: Hori, Tomohide, Yamamoto, Hidekazu, Harada, Hideki, Yamamoto, Michihiro, Yamada, Masahiro, Yazawa, Takefumi, Sasaki, Ben, Tani, Masaki, Sato, Asahi, Katsura, Hikotaro, Kamada, Yasuyuki, Tani, Ryotaro, Aoyama, Ryuhei, Sasaki, Yudai, Shintaku, Masayuki, Iwasa, Yoko, Zaima, Masazumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237700/
https://www.ncbi.nlm.nih.gov/pubmed/34158469
http://dx.doi.org/10.12659/AJCR.931668
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author Hori, Tomohide
Yamamoto, Hidekazu
Harada, Hideki
Yamamoto, Michihiro
Yamada, Masahiro
Yazawa, Takefumi
Sasaki, Ben
Tani, Masaki
Sato, Asahi
Katsura, Hikotaro
Kamada, Yasuyuki
Tani, Ryotaro
Aoyama, Ryuhei
Sasaki, Yudai
Shintaku, Masayuki
Iwasa, Yoko
Zaima, Masazumi
author_facet Hori, Tomohide
Yamamoto, Hidekazu
Harada, Hideki
Yamamoto, Michihiro
Yamada, Masahiro
Yazawa, Takefumi
Sasaki, Ben
Tani, Masaki
Sato, Asahi
Katsura, Hikotaro
Kamada, Yasuyuki
Tani, Ryotaro
Aoyama, Ryuhei
Sasaki, Yudai
Shintaku, Masayuki
Iwasa, Yoko
Zaima, Masazumi
author_sort Hori, Tomohide
collection PubMed
description Patient: Male, 60-year-old Final Diagnosis: Gastric carcinoma Symptoms: Asymptomatic Medication:— Clinical Procedure: Surgical resection Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) infections are associated with gastric carcinoma (GC). We present a thought-provoking case of multiple GCs associated with EBV and HP infections. CASE REPORT: HP infection was incidentally detected in an asymptomatic 60-year-old man. Upper endoscopy revealed gastric “kissing” ulcers. The lesions were located in the body of the stomach and measured 25 and 27 mm, respectively. They were diagnosed on pathology as moderately differentiated tubular adenocarcinoma. Imaging revealed no enlarged lymph nodes or distant metastatic lesions. Distal gastrectomy with lymphadenectomy was performed and surgical cure was obtained. The multiple GCs were categorized on pathology as infb ly0 v0 pT1b(SM)UL1N0M0H0P0CY0 pStage IA according to the Japanese classification and as T1bN0M0 Stage IA according to the tumor, node, metastasis classification. Pathological examination revealed remarkable lymphocytic infiltration into the stroma, as shown by in situ hybridization of EBV. These lymphocytic infiltrations were observed only at the sites of GC. In the immunohistochemical examination, in situ hybridization of EBV was positive for EBV-encoded small ribonucleic acid. The patient’s postoperative course was uneventful. Hence, an unexpected relationship between EBV infection and multiple GCs was suggested by pathology. Quantitative determination of EBV DNA in peripheral blood was normal postoperatively. Adjuvant chemotherapy was not recommended. HP eradication therapy was successful. The patient remained asymptomatic and developed no recurrence or metastasis for 3 years after surgery. CONCLUSIONS: This thought-provoking case suggests that coinfection with EBV and HP increases GC occurrence.
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spelling pubmed-82377002021-07-09 Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case Hori, Tomohide Yamamoto, Hidekazu Harada, Hideki Yamamoto, Michihiro Yamada, Masahiro Yazawa, Takefumi Sasaki, Ben Tani, Masaki Sato, Asahi Katsura, Hikotaro Kamada, Yasuyuki Tani, Ryotaro Aoyama, Ryuhei Sasaki, Yudai Shintaku, Masayuki Iwasa, Yoko Zaima, Masazumi Am J Case Rep Articles Patient: Male, 60-year-old Final Diagnosis: Gastric carcinoma Symptoms: Asymptomatic Medication:— Clinical Procedure: Surgical resection Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) infections are associated with gastric carcinoma (GC). We present a thought-provoking case of multiple GCs associated with EBV and HP infections. CASE REPORT: HP infection was incidentally detected in an asymptomatic 60-year-old man. Upper endoscopy revealed gastric “kissing” ulcers. The lesions were located in the body of the stomach and measured 25 and 27 mm, respectively. They were diagnosed on pathology as moderately differentiated tubular adenocarcinoma. Imaging revealed no enlarged lymph nodes or distant metastatic lesions. Distal gastrectomy with lymphadenectomy was performed and surgical cure was obtained. The multiple GCs were categorized on pathology as infb ly0 v0 pT1b(SM)UL1N0M0H0P0CY0 pStage IA according to the Japanese classification and as T1bN0M0 Stage IA according to the tumor, node, metastasis classification. Pathological examination revealed remarkable lymphocytic infiltration into the stroma, as shown by in situ hybridization of EBV. These lymphocytic infiltrations were observed only at the sites of GC. In the immunohistochemical examination, in situ hybridization of EBV was positive for EBV-encoded small ribonucleic acid. The patient’s postoperative course was uneventful. Hence, an unexpected relationship between EBV infection and multiple GCs was suggested by pathology. Quantitative determination of EBV DNA in peripheral blood was normal postoperatively. Adjuvant chemotherapy was not recommended. HP eradication therapy was successful. The patient remained asymptomatic and developed no recurrence or metastasis for 3 years after surgery. CONCLUSIONS: This thought-provoking case suggests that coinfection with EBV and HP increases GC occurrence. International Scientific Literature, Inc. 2021-06-23 /pmc/articles/PMC8237700/ /pubmed/34158469 http://dx.doi.org/10.12659/AJCR.931668 Text en © Am J Case Rep, 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Hori, Tomohide
Yamamoto, Hidekazu
Harada, Hideki
Yamamoto, Michihiro
Yamada, Masahiro
Yazawa, Takefumi
Sasaki, Ben
Tani, Masaki
Sato, Asahi
Katsura, Hikotaro
Kamada, Yasuyuki
Tani, Ryotaro
Aoyama, Ryuhei
Sasaki, Yudai
Shintaku, Masayuki
Iwasa, Yoko
Zaima, Masazumi
Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title_full Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title_fullStr Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title_full_unstemmed Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title_short Multiple Gastric Carcinomas Associated with Epstein-Barr Virus and Helicobacter pylori: A Thought-Provoking Case
title_sort multiple gastric carcinomas associated with epstein-barr virus and helicobacter pylori: a thought-provoking case
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237700/
https://www.ncbi.nlm.nih.gov/pubmed/34158469
http://dx.doi.org/10.12659/AJCR.931668
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