Correct Answer: B
Rationale
This patient has a neuroendocrine tumor (e.g., carcinoid). These tumors are derived from enterochromaffin-like cells and appear as nests or ribbons of endocrine cells. There are three types of carcinoids. Type 1 is the most common and has a benign course. Type 1 neuroendocrine tumors can be multifocal, well-differentiated and associated with type A chronic atrophic gastritis. Small tumors can be treated with endoscopic resection. Type 2 lesions tend to be multifocal and associated with Zollinger-Ellison syndrome (ZES) and multiple endocrine neoplasia 1 (MEN1). Up to 30% of type 2 tumors present with lymph node metastases. Type 3 gastric carcinoids are not associated with hypergastrinemia and have poor prognosis. Type 3 gastric carcinoids should be managed with surgery.
References
1. ASGE Standards of Practice Committee, Evans JA, Chandrasekhara V, et al. The role of endoscopy in the management of premalignant and malignant conditions of the stomach. Gastrointest Endosc. 2015;82(1):1-8.
2. Shaib YH, Rugge M, Graham DY, et al. Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol. 2013;11(11):1374-84.
