case_images: PMC10025567_01
case_images: Gastric antrum.
case_images: fonc-13-1114097-g001.jpg
case_images: PMC10025567_01_fonc-13-1114097-g001.jpg
case_images: f1
case_images: The other colonic and rectal mucosa were smooth, with clear vascular texture and no obvious abnormalities.  Figures 1 - 4  show the patient's condition under a gastroscope.
case_images: Gastric fundus.
case_images: fonc-13-1114097-g002.jpg
case_images: PMC10025567_01_fonc-13-1114097-g002.jpg
case_images: f2
case_images: The other colonic and rectal mucosa were smooth, with clear vascular texture and no obvious abnormalities.  Figures 1 - 4  show the patient's condition under a gastroscope.
case_images: Gastric body.
case_images: fonc-13-1114097-g003.jpg
case_images: PMC10025567_01_fonc-13-1114097-g003.jpg
case_images: f3
case_images: The other colonic and rectal mucosa were smooth, with clear vascular texture and no obvious abnormalities.  Figures 1 - 4  show the patient's condition under a gastroscope.
case_images: Gastric body.
case_images: fonc-13-1114097-g004.jpg
case_images: PMC10025567_01_fonc-13-1114097-g004.jpg
case_images: f4
case_images: The other colonic and rectal mucosa were smooth, with clear vascular texture and no obvious abnormalities.  Figures 1 - 4  show the patient's condition under a gastroscope.
case_images: Under the microscope, the glandular cavity of the gastric body is irregular in shape, manifested as expansion or distortion, and there are small glandular cavities around, mucosal interstitial edema, accompanied by infiltration of chronic inflammatory cells. (A. 40x; B. 200x).
case_images: fonc-13-1114097-g005.jpg
case_images: PMC10025567_01_fonc-13-1114097-g005.jpg
case_images: f5
case_images: Pathological findings suggest the following: 1. (gastric fundus biopsy) mucosa high-grade intraepithelial neoplasia; 2. (gastric biopsy) juvenile polyps ( Figure 5 ); 3. (sigmoid colon biopsy) Low-grade tubular adenoma with clean margins.
case_images: Schematic diagram of SMAD4 gene pathogenic variant.
case_images: fonc-13-1114097-g006.jpg
case_images: PMC10025567_01_fonc-13-1114097-g006.jpg
case_images: f6
case_images: Gene testing of the patient and his brother showed that the SMAD4: c.266_269del pathogenic variant was present in exon 3 of the SMAD4 gene ( Figure 6 ).