Endoscopic surveillance of gastric cancers after Helicobacter pylori eradication

Figure 5 Gastric cancer progressed after eradication therapy. A: A review of the endoscopic pictures taken 3 years earlier revealed the presence of a discolored and flat elevated lesion adjacent to a xanthoma (arrow) in the cardia; B: This lesion was not clear yet, but the xanthoma had almost disappeared (arrow); C: The biopsy specimen taken from the lesion showed foveolar-type epithelium with mild structural atypia; D: After follow-up for 1 yr, the tumor had become evident and covered by mucus; E: The tumor had invaded into the deep submucosal layer, but the mucosal element was preserved; F: This cancer showed a gastric mucin phenotype with low-grade atypia[26].