A Case of Squamous Metaplasia of the Stomach
A 79-year-old man had undergone an endoscopic submucosal dissection for a gastric adenoma with low grade dysplasia 3 years ago. The final histological diagnosis was low grade dysplasia, equal to the preresectional diagnosis. Then he underwent surveillance endoscopy annually. There was no abnormal finding on first and second follow-ups. However, at the third visit, a conventional endoscopy revealed a whitish flat lesion in the lesser curvature of cardiac region of the stomach (), the lesion which was away from the scar area which occurred after the endoscopic resection of the adenoma. In addition, the whitish lesion was distinctly away from the normal esophageal mucosa, but its appearance looked like normal esophageal mucosa. Therefore, chromoendoscopy using Lugol's iodine solution was performed to make sure whether the lesion was squamous mucosa or not. When Lugol's iodine solution was applied, the lesion was stained brown in the same way as normal esophageal mucosa (). The endoscopic biopsy from the whitish lesion revealed stratified squamous epithelial mucosa (). The final diagnosis was gastric squamous metaplasia.