Abstract
Gastric signet ring cell carcinoma is a rare and highly malignant adenocarcinoma, which is characterized by early metastasis, rapid progression and poor prognosis. Several studies have shown that early-stage gastric signet ring cell carcinoma may have equal or better prognosis than other types of gastric cancer. However, most of the early-stage lesions are difficult to detect by endoscopy. Two female cases of early-stage gastric signet ring cell carcinoma with atrophic background mucosa occurring in the middle and lower part of the stomach were found in our endoscopy center. The diagnosis was confirmed by upper gastrointestinal white light endoscopy combined with narrow-band imaging and endoscopic biopsy, both lesions less than 2.0cm in diameter were surgically removed and identified as intramucosal adenocarcinoma. Through these two cases, we aim to illustrate the difficulty of early detection of gastric signet ring cell carcinoma with mucosal atrophy. We can roughly identify the demarcation of the lesion by combining white light endoscopy and narrow-band imaging, and slightly irregular microsurface and microvascular pattern of the lesion were found via magnifying endoscopic observation, but the demarcation can hardly be accurately identified.
Diagnosis of small intramucosal signet ring cell carcinoma of the stomach by non-magnifying narrow-band imaging: A pilot study
