2023 Volume 50 Issue 6 Pages 544-548
As the decrease of Helicobacter pylori (H.pylori) infection rate, the incidence of H.pylori-uninfected gastric cancer is gradually increasing, and it was revealed that there are various histopathological type of H.pylori-uninfected gastric cancers. Gastric foveolar-type adenocarcinoma, which appears reddish and protruded in H.pylori-uninfected gastric mucosa, is known as "raspberry-like Gastric foveolar-type adenocarcinoma". Whereas, other histopathological types of gastric lesions which resemble for raspberry in H.pylori-uninfected gastric mucosa have been also reported. We define gastric lesions which resemble for raspberry as RSGL (raspberry shaped gastric lesion). We describe endoscopic and clinicopathological features of each histopathological type of RSGLs, and endoscopic differential diagnoses. RSGLs are classified into five histopathological types: gastric adenocarcinoma of foveolar type (GA-FV), gastric adenocarcinoma of fundic-gland type (GA-FG), gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM), hyperplastic polyp (HP), and proton pump inhibitor-related lesion (PPI-L). GA-FV lesions have homogenously reddish and exhibited only polygonal/curved marginal crypt epithelium (MCE) without a subepithelial lesion (SEL) shape. GA-FG lesions have heterogeneous reddish with a SEL shape. GA-FGM lesions have homogenous reddish with a SEL shape. HP and PPI-L have homogenous reddish and exhibited polygonal/curved and linear/dotted MCE without a SEL shape. The diagnostic algorithm for RSGLs based on these endoscopic features is useful for endoscopic differentiation of RSGLs.