case_images: PMC11215040_01
case_images: Endoscopic findings of the patient in Case 1. (A) Normal antrum. (B) The greater curvature of the corpus displayed an irregular distribution of folds, with deep fissure-like structures and localized yellowish-white discoloration. (C, D) Yellowish-white cobblestone-like elevations were noted in the lesser curvature of the corpus, accompanied by irregular distribution of CVs (purple arrows) on the surface. (E) Whitish areas with elongated and widened CVs were detected in the lesser curvature of the corpus. (F) Magnifying endoscopy with narrow-band imaging did not reveal significant mucosal swelling.
case_images: fimmu-15-1416292-g001.jpg
case_images: PMC11215040_01_fimmu-15-1416292-g001.jpg
case_images: f1
case_images: Endoscopic examination revealed a normal antral mucosa ( Figure 1A ). The greater curvature of the corpus exhibited an irregular distribution of folds with deep fissure-like structures and a localized yellowish-white color ( Figure 1B ). Closer examination of the surface revealed an irregular distribution of localized CVs ( Figures 1C, D ). Magnifying endoscopy with narrowband imaging did not reveal any significant mucosal swelling ( Figures 1E, F ).
case_images: Histopathological findings from different regions of the patient's stomach in Case 1 and a healthy control case. (A, B) Tissue obtained from the corpus of the patient in Case 1 revealed the arrangement of the parietal cells exhibiting irregularities, characterized by pseudohypertrophy (green arrows) and protrusions into the lumen (yellow arrows). (C, D) Normal corpus. (E, G, I, K, M, O, P) were comparisons of differential staining in the same region of (A, F, H, J, L, N) were comparisons of differential staining in the same region of (C). (E) H+/K+ATPase staining revealed areas where the parietal cells remained. (F) Normal H+/K+ATPase staining. (G) Chromogranin A staining exhibited no significant proliferation of enterochromaffin-like cells. (H) Normal Chromogranin A staining. (I, K) Pepsinogen I and MUC6 staining revealed that mucous neck cells appeared at the base of corpus glands (red square). (J) Normal Pepsinogen I staining. (L) Normal MUC6 staining. (M) CD3 staining revealed a small amount of lymphocytic infiltration. (N) Normal CD3 staining. (O, P)
  H. pylori staining revealed absence of H. pylori.
  (Q, R) The tissue obtained from the antrum of the patient in Case 1 revealed an absence of inflammation or atrophy but G cell hyperplasia (Orange arrows). (S, T) Normal antrum. (U, W, Y, Z) were a comparison of differential staining in the same region of (Q, V, X) were a comparison of differential staining in the same region of (S). (U) Gastrin staining indicated the proliferation of G cells hyperplasia. (V) Normal Gastrin staining. (W) CD3 staining revealed a lack of significant lymphocytic infiltration. (X) Normal CD3 staining. (Y, Z)
  H. pylori staining revealed absence of H. pylori.
case_images: fimmu-15-1416292-g002.jpg
case_images: PMC11215040_01_fimmu-15-1416292-g002.jpg
case_images: f2
case_images: H. pylori staining results of corpus; ( Figures 2Q-T ) shows the HE staining results of antrum; ( Figures 2U, V ) shows the Gastrin staining results of antrum; ( Figures 2W, X ) shows the CD3 staining results of antrum; ( Figures 2Y, Z ) shows the H. pylori staining results of antrum. Among them, histopathological examination of tissue obtained from the gastric corpus showed no significant atrophy of the gastric glandular cells; however, the arrangement of the parietal cells began to exhibit irregularities characterized by hyperplasia and protrusions into the lumen ( Figures 2A, B ). H+/K+ ATPase staining revealed no significant detachment of the parietal cells ( Figure 2E ). Chromogranin A staining revealed no significant proliferation of enterochromaffin-like cells ( Figure 2G ). Pepsinogen I and MUC6 staining showed that the mucous neck cells appeared at the base of corpus glands ( Figures 2I, K ). CD3 staining revealed a small amount of lymphocytic infiltration ( Figure 2M ). H. pylori staining did not reveal the presence of H. pylori ( Figures 2O, P ). G cell hyperplasia ( Figures 2Q, R ). Gastrin staining indicated the proliferation of G cells ( Figure 2U ). CD3 staining revealed no significant lymphocytic infiltration ( Figure 2W ). H. pylori staining did not reveal the presence of H. pylori ( Figures 2Y, Z ).
case_images: PMC11215040_02
case_images: Endoscopic findings of the patient in Case 2. (A) Normal antrum. (B) Smooth mucosa with consistently thick folds were present in the greater curvature of the corpus. (C) Regular arrangement of CVs was visible on the mucosal surface of the fundus. (D) Some yellowish-white cobblestone-like elevations were present in the lesser curvature of the corpus, and an irregular distribution of CVs (purple arrows) on the surface was observed. (E) Magnifying endoscopy with narrow-band imaging revealed distinct CVs on the surface of the swollen mucosa. (F) The indigo carmine staining highlighted the gastric-area swelling.
case_images: fimmu-15-1416292-g003.jpg
case_images: PMC11215040_02_fimmu-15-1416292-g003.jpg
case_images: f3
case_images: Endoscopic examination revealed no inflammation or atrophy of the antral mucosa ( Figure 3A ). Smooth mucosa with consistently thick folds was observed in the greater curvature of the corpus ( Figure 3B ). The fundus mucosa displayed no signs of atrophy and exhibited a distinct and orderly arrangement of CVs ( Figure 3C ). Yellowish-white cobblestone-like elevations were noted on the lesser curvature of the corpus, indicating an irregular morphology and distribution of CVs upon closer examination ( Figure 3D ). Magnifying endoscopy with narrow-band imaging revealed distinct CVs on the surface of the swollen mucosa ( Figure 3E ). Indigo carmine staining revealed gastric area swelling ( Figure 3F ).
case_images: Histopathological findings from different regions of the patient's stomach in Case 1 and a healthy control case. (A, B) Tissue was obtained from the corpus of the patient in Case 1. The parietal cells began to pseudohypertrophy (green arrows) and protrusion into the lumen (yellow arrows). (C, D) Normal corpus. (E, G, I, K, M, O, P) were comparisons of differential staining in the same region of (A, F, H, J, L, N) were comparisons of differential staining in the same region of (C). (E) H+/K+ATPase staining revealed that the number of parietal cells was not significantly reduced. (F) Normal H+/K+ATPase staining. (G) Chromogranin A staining exhibited no significant proliferation of enterochromaffin-like cells. (H) Normal Chromogranin A staining. (I) Pepsinogen I staining revealed that chief cells were preserved. (J) Normal Pepsinogen I staining. (K) MUC6 staining revealed that mucous neck cells were preserved. (L) Normal MUC6 staining. (M) CD3 staining revealed no significant lymphocytic infiltration. (N) Normal CD3 staining. (O, P)
  H. pylori staining revealed absence of H. pylori.
  (Q) Tissue was obtained from the antrum of the patient in Case 1. No inflammation or atrophy was present. (R) Normal antrum. (S, U, W, X) were a comparison of differential staining in the same region of (Q, T, V) were a comparison of differential staining in the same region of (R). (S) Gastrin staining did not demonstrate notable proliferation of G cells. (T) Normal Gastrin staining. (U) CD3 staining revealed no significant lymphocytic infiltration. (V) Normal CD3 staining. (W, X)
  H. pylori staining revealed absence of H. pylori.
case_images: fimmu-15-1416292-g004.jpg
case_images: PMC11215040_02_fimmu-15-1416292-g004.jpg
case_images: f4
case_images: ATPase staining results of corpus; ( Figures 4G, H ) shows the CgA staining results of corpus; ( Figures 4I, J ) shows the PGI staining results of corpus; ( Figures 4K, L ) shows the MUC6 staining results of corpus; ( Figures 4M, N ) shows the CD3 staining results of corpus; ( Figures 4O, P ) shows the H. pylori staining results of corpus; ( Figures 4Q, R ) shows the HE staining results of antrum; ( Figures 4S, T ) shows the Gastrin staining results of antrum; ( Figures 4U, V ) shows the CD3 staining results of antrum; ( Figures 4W, X ) shows the H. pylori staining results of antrum. Among them, histopathological examination of the tissue obtained from the gastric corpus revealed pseudohypertrophy of the parietal cells protruding into the lumen ( Figures 4A, B ). Staining for H+/K+ ATPase ( Figure 4E ), Pepsinogen I ( Figure 4I ), and MUC6 ( Figure 4K ) revealed that the parietal cells were not significantly diminished, while chief cells and mucous neck cells were well preserved. Chromogranin A staining revealed no significant proliferation of enterochromaffin-like cells ( Figure 4G ). CD3 staining did not indicate notable lymphocytic infiltration ( Figure 4M ). H. pylori staining did not reveal the presence of H. pylori ( Figures 4O, P ). Histopathological examination of the tissue collected from the antrum showed no significant signs of inflammation or atrophy ( Figure 4Q ). Gastrin staining did not show significant proliferation of G cells ( Figure 4S ). CD3 staining did not indicate notable lymphocytic infiltration ( Figure 4U ). H. pylori staining did not reveal the presence of H. pylori ( Figures 4W, X ).