Premium
Epstein‐Barr virus‐positive multiple early gastric cancers and dysplastic lesions: A case report
Author(s) -
Arikawa Junkou,
Tokunaga Masayoshi,
Tashiro Yukie,
Tanaka Sadao,
Sate Eiichl,
Haraguchi Kaname,
Yamamoto Arihiro,
Toyohira Osamu,
Tsuchimochi Akio
Publication year - 1997
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1997.tb04450.x
Subject(s) - pathology , medicine , epstein–barr virus , virus , virology
Epstein‐Barr vlrus (EBV) has been implicated as a causal virus of gastrlc cancer with episomal monoclonality, elevated antibodles and a unlque morphologlc expression in the early intramucosal stage, but the infection mechanisms have not been demonstrated. EBV has been shown only in the cancerous lesions by the highly sensltlve EBVencoded small RNA in situ hybridization (EBER‐ISH) method, not in the dysplastic mucosa adjacent to the cancer. A case is presented of multiple EBV‐positive gastric cancer and dysplastic epithelium observed In a 52‐year‐old man. Serlai cut sections of the gastrectomy specimen showed four small cancerous lesions, three of which were EBER‐posltlve, and three EBER‐positive, minute, non‐cancerous dysplastic lesions. The three cancerous lesions were intramucosal cancer, with one having minimal submucosal invasion forming 8 lymphoeplthelioma‐like histology. All of these EBER‐posltlve cancerous and dysplastic lesions showed Intense CD8T‐lyrnphocytic Infiltration. There was no such findings in the EBV‐negative cancerous lesion. It was concluded that EBV infection may occur in the epitheilal cells of atrophic gastric mucosa, and progress to cancer with monoclonal expansion through the EBV‐positive dysplastic change. Cytotoxlc T‐lymphocytic reactions can occur even in the dysplastic lesions. Multifocal EBV infection in the gastric mucosa may occur and, if necessary, total gastrectomy Is recommended in such a case.