Parietal Cell Dysfunction: A Rare Cause of Gastric Neuroendocrine Neoplasm with Achlorhydria and Extreme Hypergastrinemia

Intern Med. 2022 Aug 15;61(16):2441-2448. doi: 10.2169/internalmedicine.8253-21. Epub 2022 Feb 1.

Abstract

A 69-year-old woman with multiple neuroendocrine neoplasms (NENs) was referred to our hospital. Although she had extreme hypergastrinemia (11,675 pg/mL), no findings that indicated types I to III gastric NENs were found. Although gastric corpus atrophy was suspected on conventional white-light imaging, findings on magnifying endoscopy with narrow-band imaging indicated no severe atrophy. A biopsy from the background fundic gland mucosa revealed no atrophic changes, parietal cells with vacuolated cytoplasm and negative findings for H+K+-ATPase. Thus, this case was diagnosed as multiple NENs with parietal cell dysfunction. Neither progression nor metastasis has been confirmed during two-year follow-up.

Keywords: achlorhydria; hypergastrinemia; neuroendocrine neoplasms; parietal cell dysfunction.

Publication types

  • Case Reports

MeSH terms

  • Achlorhydria* / etiology
  • Achlorhydria* / pathology
  • Aged
  • Atrophy / pathology
  • Female
  • Gastric Mucosa / pathology
  • Gastritis, Atrophic* / pathology
  • Humans
  • Neuroendocrine Tumors* / complications
  • Neuroendocrine Tumors* / diagnostic imaging
  • Neuroendocrine Tumors* / pathology
  • Parietal Cells, Gastric / metabolism
  • Parietal Cells, Gastric / pathology
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / pathology