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Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer
Kyoungwon Jung, Moo In Park, Sung Eun Kim, Seun Ja Park
Clin Endosc 2016;49(4):336-345.   Published online July 25, 2016
DOI: https://doi.org/10.5946/ce.2016.057
AbstractAbstract PDFPubReaderePub
Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic and pathological differences is necessary, especially for LP type GCs in the developmental stage. In conclusion, diagnosis of pre-stage or latent LP type GC before progression to typical LP type GC requires the detection of IIc-like lesions in the fundic gland area. It is also crucial to identify any abnormalities such as sclerosis of the gastric wall and hypertrophy of the mucosal folds during endoscopy.

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A Case of Borrmann Typer 4 Cancer that was Suspected to be Eosinophiic Gastritis
Hyun Ho Choi, M.D., Chang Nyol Paik, M.D., U-Im Chang, M.D., Sung Hoon Jung, M.D., Jeong Rok Lee, M.D., Woo Chul Chung, M.D., Kang-Moon Lee, M.D. and Jin-Mo Yang, M.D.
Korean J Gastrointest Endosc 2008;37(6):419-423.   Published online December 30, 2008
AbstractAbstract PDF
Borrmann type 4 gastric is a malignant disease that shows enlarged gastric folds, and this is easily mistaken as a mucosal flare or as inflammation because a third of these patients show normal mucosa without mucosal defects and the lesion diffusively infiltrates into the submucosal area. Endoscopic ultrasonography is an effective tool for making the differential diagnosis of gastric subepithelial lesion and hypertrophic gastric fold when endoscopy is not suitable to use. Eosinophilic gastritis is a benign lesion with enlarged gastric folds and it shows pathologic eosinophil infiltration in the walls of the stomach. We report here on a case that was suspected to be Borrmann type 4 advanced gastric cancer according to the endoscopic ultrasonography and this was confirmed by abdominal operation. Otherwise, this condition would have been mistaken for eosinophilic gastritis. (Korean J Gastrointest Endosc 2008;37:419-423)
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