Endoscopic Observation of Squamous Metaplasia of the Stomach: A Report of Two Cases

Squamous metaplasia of the stomach is a rare clinical entity that occurs during healing of gastric ulcers or chronic inflammation. We have treated two patients with this condition, which has only occasionally been observed endoscopically. The first was a 60-year-old woman who initially presented with multiple gastric ulcers. Two months after treatment, a white patch about 4 cm in diameter was found in the lesser curvature of the cardiac region of stomach. The second patient was a 65-year-old woman, who also developed a white patch in the same region. Two months later, a small ulcer and inflamed mucosa were seen near the lesion. The white areas in both patients were stained with Lugol's iodine solution, and biopsy specimens confirmed squamous epithelium. The squamous metaplasia was observed as a white mucosal area in the stomach, and the metaplastic area stained positively with Lugol's iodine solution.

References

• 1 Correa P. Chronic gastritis. In: Whitehead R (ed). Gastrointestinal and oesophageal pathology.  London; Churchill Livingstone, 1989: 401-420
• 2 Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis: the updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994.  Am J Surg Pathol. 1996;  20 1161-1181
• 3 Tolia V, Chang C, Emami A. Juvenile onset pernicious anemia, partial intestinal atrophy, ulcerative colitis, and squamous metaplasia of the stomach.  Am J Gastroenterol. 1986;  81 803-807
• 4 Saliler S. Diffuse metaplastic gastritis in a patient with prolonged cachexia and macrocytic anemia.  Arch Pathol. 1943;  35 730-743
• 5 Singar HA. Leukoplakia of the stomach: report of a case.  Arch Pathol. 1930;  22 676-682
• 6 Vaughan WP, Straus FH, Paloyan D. Squamous carcinoma of the stomach after luetic linitis plastica.  Gastroenterol. 1977;  72 945-948
• 7 Watson GW, Flint ER, Stewart MJ, et al. Hyperplastic tuberculosis of the stomach causing hour-glass deformity, with complete squamous metaplasia of the upper loculus.  Br J Surg. 1936;  24 333-340
• 8 Eaton H, Tennekoon GE. Squamous carcinoma of the stomach following corrosive acid burns.  Br J Surg. 1972;  59 382-387
• 9 Boswell JR, Helwig EB. Squamous cell carcinoma and adenocarcinoma of the stomach: a clinicopathologic study.  Cancer. 1965;  18 181-192
• 10 Fujino K, Ichikura T, Ikawa H, et al. A report of malignant lymphoma of the stomach developing diffuse squamous metaplasia during follow-up.  Gastroenterol Endosc. 1992;  34 1895-1899
• 11 Yamagiwa H, Yoshimura H, Nishii M, et al. Squamous metaplasia of the gastric mucosa associated with an aberrant pancreas.  Gan No Rinsho. 1987;  33 1929-1932
• 12 Gillen P, Keeling P, Byrne PJ, et al. Barrett's oesophagus: pH profile.  Br J Surg. 1987;  74 774-776
• 13 Feurle GE, Helmstaedter V, Buehring A, et al. Distinct immunohistochemical findings in columnar epithelium of esophageal inlet patch and of Barrett's esophagus.  Dig Dis Sci. 1990;  35 86-92
• 14 Beck F, Chawengsaksophak K, Waring P, et al. Reprogramming of intestinal differentiation and intercalary regeneration in Cdx2 mutant mice.  Proc Natl Acad Sci USA. 1999;  96 7318-7323
• 15 Anbazhagan R, Raman V. Homeobox genes: molecular link between congenital anomalies and cancer.  Eur J Cancer. 1997;  33 635-637
• 16 Boland CR, Scheiman JM. Tumor of the stomach.  In: Yamada T (ed). Textbook of gastroenterology, 2nd ed. Textbook of gastroenterology, 2nd ed.  Philadelphia; Lippincott, 1995: 1494-1523
• 17 Hameetemen W, Tytgat GN, Houthoff HJ, et al. Barrett's esophagus: development of dysplasia and adenocarcinoma.  Gastroenterology. 1989;  96 1249-1256