Clinicopathological features of early gastric cancers arising in Helicobacter pylori uninfected patients

Figure 1 Fundic gland type adenocarcinoma. A: Cancer cells with enlarged nuclei formed irregular glands. The surface of the tumor was covered with non-cancerous epithelium, hematoxylin and eosin, original magnification 4 ×; B: The tumor invaded into the submucosal layer in a state that kept the muscularis mucosa. The distance from muscularis mucosa was 75 μm, hematoxylin and eosin, original magnification 40 ×; C: PG-I stains showed focal positive for cancer cells; D: The submucosal tumor like a small protrusion on the greater curvature of the upper gastric body, white light endoscopy; E: The surface of the tumor was covered with normal epithelium, magnifying endoscopy with narrow-band imaging.

Figure 2 Foveolar type adenocarcinoma. A: The villous structure composed of dysplastic columnar cells with clear cytoplasm. Hematoxylin and eosin, original magnification 4 ×; B: MUC5AC was positive for cancer; C: MUC6 was negative for cancer but positive for expanded noncancerous glands in the middle layer of mucosa; D: Whitish laterally spreading elevated lesion was seen at the greater curvature of the upper gastric body, white light endoscopy; E: A papillary or villous like fine mucosal pattern with intra-structural irregular vessels in all lesions, one lesion showed raspberry-like appearance magnifying endoscopy with narrow-band imaging; F: One lesion showed raspberry-like appearance.

Figure 3 Intestinal-type adenocarcinoma. A: The tubular structures lined by tall columnar cells with hyperchromatic, pencillate, and pseudostratified nuclei, hematoxylin and eosin, original magnification 4 ×; B: MUC2 was weakly positive for cancer cells; C: CD10 was positive for cancer cells; D: 0-IIa+IIc type tumor mimicking verrucosa on the gastric antrum, white light endoscopy; E: An irregular microvascular pattern and irregular microsurface pattern with a demarcation line were observed just in the recessed area, magnifying endoscopy with narrow-band imaging.

Figure 4 Pure signet-ring cell carcinoma. A, B: Pure signet ring cell carcinoma were observed proliferative zone to the surface layer of mucosa, hematoxylin and eosin, A: Original magnification 4 ×; B: High magnification 40 ×; C: Discolored slightly depressed lesion on the gastric antrum, white light endoscopy; D: The surface of the tumor was covered with normal mucosa, magnifying endoscopy with narrow-band imaging