A case study of gastritis cystica profunda mimicking a submucosal tumor treated with endoscopic submucosal dissection

Gastritis cystica profunda (GCP) is a rare gastric condition characterized by glandular hyperplasia and cystic dilatation extending from the gastric mucosa into the submucosa. It is considered a potential precancerous lesion, yet its diagnosis remains challenging due to the absence of distinct clinical manifestations. Notably, chronic Helicobacter pylori infection may contribute to its pathogenesis through sustained mucosal inflammation.

A 63 year-old male underwent gastroscopy, which revealed a submucosal protrusion lesion on the lesser curvature of the posterior gastric antrum. Microvascular thickening on the lesion surface was detected through narrow-band imaging. In the endoscopic ultrasonography, multiple hypoechoic to anechoic lesions arising from the submucosal layer were identified, and a space-occupying lesion in the gastric antrum was detected using contrast-enhanced abdominal computed tomography. Endoscopic submucosal dissection was performed, and varying degrees of cystic dilatation of mucosal and submucosal glands were confirmed in histopathological examination, establishing the diagnosis of GCP.

GCP may present as a submucosal tumor-like lesion on white-light endoscopy, with histopathological assessment remaining the diagnostic gold standard. Endoscopic submucosal dissection serves as a safe and effective therapeutic approach and can be considered a first-line treatment option.