1/152. Primary advanced gastric small cell carcinoma: a case report and review of the literature.We report a 73-yr-old man with primary advanced gastric small cell carcinoma, pure type. A large, Borrman type I tumor was located from the cardia to the entire gastric fundus and upper body. Atypical cells showed a round nucleus, small nucleolus, dense to granular chromatin, and scant cytoplasm. The histological findings indicates an advanced stage and exposure to the gastric serosa. Mitotic figures were observed. There was a proliferation of a sheet-like, solid pattern, but no rosette-like, sqamoid, or glandular patterns. The neoplastic cells were positive for Leu-7 (CD57) and 123C3 (CD56, neural cell adhesion molecule, NCAM) on the surface membrane. We diagnosed this case as primary advanced gastric small cell carcinoma, pure type, and report that Leu-7 and 123C3 monoclonal antibodies are useful markers for gastric small cell carcinoma. The 32 previously reported cases of gastric small cell carcinoma are also reviewed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/152. Completely laparoscopic resection of a rare pyloric tumor with laparoscopically sutured gastroduodenostomy.We report the case of a 31-year-old woman who presented with epigastric pain and weight loss. Esophagogastroduodenoscopy revealed a submucosal mass in the distal antrum and pylorus. Endoscopic biopsy of the mass was nondiagnostic. A CT scan confirmed a 3.0-cm mass in the posterior wall of the distal antrum. She underwent laparoscopic resection of the distal antrum and pylorus with end-to-end gastroduodenostomy. Pathologic examination showed an adenomyoma of the antrum and pylorus. Her postoperative course was uncomplicated, and she continues to do well 38 months postoperatively. Gastric adenomyoma is a rare, benign intramural tumor of the antrum and pylorus. Fewer than 40 cases have been described in the literature. The lesions are generally within 4 cm of the pylorus. Histologically, they are characterized by ductal structures lined by cuboidal to columnar epithelium surrounded by smooth muscle bundles and, occasionally, Brunner's-type glands and heterotopic pancreas. Treatment is by resection, and recurrence has not been reported. Laparoscopic resection of portions of the stomach has been reported. Side-to-side gastrojejunostomies (Billroth II) performed laparoscopically have been reported. This is the first report in the English-language literature of a completely laparoscopically performed sutured gastroduodenostomy. Technical details of the procedure and adenomyomas are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/152. Gastric adenocarcinoma with tonsil and submaxillary gland metastases: case report.Local invasion, hematogenous and lymphatic metastases are the major modes of spreading gastric cancer. The most common sites of metastases in patients with gastric cancer are liver, peritoneum, omentum, lungs and mesentery. Of the two pathological types of gastric cancer, intestinal-type gastric cancer showed preferential metastasis to the liver, whereas the diffuse-type showed a preference for peritoneal involvement and lymph node metastasis. However, metastases of gastric cancer to the head and neck regions are not common. The hematogenous route appears to account for a great majority of metastases to the head and neck regions. Malignant neoplasm metastases to major salivary glands or tonsils are not common. Several patients with cancers from the infraclavicular area have been reported with parotid gland or tonsil metastases. However, metastasis of gastric adenocarcinoma to the tonsils or submandibular glands is rare. We present a patient with recurrent gastric adenocarcinoma with both tonsil and submandibular gland metastases which is even rarer.- - - - - - - - - - ranking = 8keywords = gland (Clic here for more details about this article) |
4/152. Gastric adenocarcinoma associated with fundic gland polyps in a patient with attenuated familial adenomatous polyposis.Familial adenomatous polyposis (FAP) is a rare autosomal dominant precancerous condition of the colon caused by mutations in the adenomatous polyposis coli (APC) tumor suppressor gene. FAP is characterized by the appearance of innumerable adenomatous polyps throughout the large bowel. Fundic gland polyps are the most common gastric lesion in FAP. It is generally believed that fundic gland polyps have little or no potential for malignant transformation in the population at large, and only a few case reports describe the development of high grade dysplasia or gastric adenocarcinoma associated with diffuse fundic gland polyposis in patients with FAP. We report the second case of gastric adenocarcinoma intimately associated with fundic gland polyposis in a family with an attenuated form of FAP. The patient had undergone routine screening per current guidelines because of his known mutation in the APC gene. This suggests that malignant transformation of fundic gland polyps in patients with FAP occur more frequently than previously believed. Current screening recommendations may not be sufficient for patients with FAP or its attenuated forms.- - - - - - - - - - ranking = 9keywords = gland (Clic here for more details about this article) |
5/152. yolk sac tumor of the stomach with an adenocarcinomatous component: a case report with immunohistochemical analysis.A 56-year-old male treated for a gastric yolk sac tumor with an adenocarcinomatous component is described. A mixed area of reticular and glandular neoplastic components was morphologically identified in this tumor. Immunohistochemically, the yolk sac tumor expressed alpha-fetoprotein (AFP), placental alkaline phosphatase (PLAP), and cytokeratin, but was negative for carcinoembryonic antigen (CEA). The adenocarcinoma was positive for CEA and cytokeratin, partially positive for PLAP, and negative for AFP. In the mixed area, the tumor cells were positive for cytokeratin, weakly expressed AFP and PLAP, and sporadically stained for CEA both in the reticular and glandular components. This area was identified as a transitional area of the yolk sac tumor and adenocarcinoma. These findings demonstrate that the yolk sac and adenocarcinomatous components are closely related. It also suggests that the tumor arose from multipotential neoplastic mucosal epithelial cells with both yolk sac and gastric mucosal phenotypes.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
6/152. Gastric adenocarcinomas in displaced mucosal glands.Although gastric carcinoma is one of the most common cancers worldwide, only a few histologic proximate precursors have been demonstrated. Several authors have found that foci of misplaced gastric mucosa with cystic dilatations (s.c. heterotopic mucosa) are often associated with gastric adenocarcinomas. However, adenocarcinomas originating within heterotopic gastric mucosa have never been reported. In present work, the review of 213 consecutive gastrectomy specimens in Japanese patients showed heterotopic gastric mucosa in 20.1% (n = 43). Up to 18 foci per gastrectomy were present. The heterotopic mucosa was surrounded by invaginations of the muscularis mucosae which showed strong positivity for smooth muscle actin. In 3 of the 213 specimens, an adenocarcinoma was found within a focus of heterotopic gastric mucosa. All 3 adenocarcinomas had cystic dilatations lined by neoplastic columnar epithelium with polymorphic nuclei, irregular nuclear membrane, large irregular nucleoli and pathological mitosis. The tumors had lateral bundles of smooth muscle (smooth muscle actin positive), regarded as invaginations of the muscularis mucosae. The p53 protein was strongly overexpressed in all 3 tumors. The heterotopic gastric mucosa may be one mucosal locus from which gastric adenocarcinomas may originate.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
7/152. Coexistent gastric MALT lymphoma and Kaposi sarcoma in an hiv positive patient.A 47 year old hiv positive male presented with haematemesis and epigastric pain. A gastrectomy was performed for intractable bleeding. The cause of the haematemesis proved to be a Kaposi sarcoma of the stomach which had resulted in mucosal ulceration. Several other smaller foci of Kaposi sarcoma were also present. Coexistent with the Kaposi sarcoma was a dense lymphoid infiltrate with lymphoid follicles and reactive germinal centres. Centrocyte-like cells caused marked effacement and destruction of gastric glands with the formation of lymphoepithelial lesions, typical of a MALT lymphoma. These cells were of B cell lineage and some expressed the hiv antigen, p24. Follicular dendritic cells and macrophages within germinal centres were also p24 positive. immunohistochemistry and in situ hybridisation did not detect Epstein-Barr virus. Although helicobacter pylori was not identified by light microscopy in the sections sampled, this does not preclude its possible role, with other cofactors such as hiv, in the causation of the MALT lymphoma.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/152. Gastric and gingival localization of mucosa-associated lymphoid tissue (MALT) lymphoma. An immunohistochemical, virological and clinical case report.Non-Hodgkin's lymphomas (NHL) of the mucosa-associated lymphoid tissue (MALT) are characterized by their mucosal and glandular tissue localization. The case described here falls into the European-American classification of a low-grade B-cell lymphoma of the MALT type, with a gingival lesion 2 years after a gastric lesion. The pathogenetic mechanisms of NHL in oral MALT and the diagnosis and treatment are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/152. Metastasizing signet ring cell carcinoma of the stomach-mimicking bilateral inflammatory breast cancer.We describe a case of unusual metastases of a gastric carcinoma to the female breast, there likely to be an inflammatory breast cancer. A 46-year-old woman was admitted to our institution with bilateral breast tumors, not typical for a breast cancer as tumor growth was synchronically bilateral within a very short period of only 2 months. The woman underwent a palliative gastrectomy 3 months before for a poorly differentiated adenocarcinoma with signet ring appearance presenting as linitis plastica. At the time of the first operation the mammary glands were not suspicious. breast biopsies assured metastases of the gastric cancer. In addition to this case report, a short overview of the literature concerning the very few cases of metastases of gastric cancer to the breast is given.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/152. gastric mucosa as an additional extrahepatic localization of hepatitis c virus: viral detection in gastric low-grade lymphoma associated with autoimmune disease and in chronic gastritis.The hepatitis c virus (HCV) has been linked to B-cell lymphoproliferation and autoimmunity, and has been localized in several tissues. The clinical observation of an HCV-infected patient with sjogren's syndrome (SS) and helicobacter pylori (HP) positive gastric low-grade B-cell non-Hodgkin's lymphoma (NHL), which did not regress after HP eradication, led us to investigate the possible localization of HVC in the gastric microenvironment. HCV genome and antigens were searched in gastric biopsy specimens from the previously mentioned case, as well as from 9 additional HCV-infected patients (8 with chronic gastritis and 1 with gastric low-grade B-cell NHL). HCV-specific polymerase chain reaction (PCR) and immunohistochemistry procedures were used. The gastric B-cell NHL from the patient with SS was characterized by molecular analyses of B-cell clonality. HCV rna was detected in both the gastric low-grade B-cell NHL and in 3 out of 6 gastric samples from the remaining cases. HCV antigens were detected in the residual glandular cells within the gastric B-cell NHL lesions, in glandular cells from 2 of the 3 additional gastric lesions that were HCV positive by PCR, and in 1 additional chronic gastritis sample in which HCV-rna studies could not be performed. By molecular analyses, of immunoglobulin genes, the B-cell NHL from the patient with SS was confirmed to be a primary gastric lymphoma, subjected to ongoing antigenic stimulation and showing a significant similarity with rheumatoid factor (RF) and anti-HCV- antibody sequences. Our results show that HCV can localize in the gastric mucosa.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
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