1/389. A case report of gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation.We report herein an unusual gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation in a 63-year-old Japanese male. The tumor was a pedunculated large polypoid tumor (7 x 6.5 x 3.5 cm) located in the pylorus. Histologically, it invaded to the subserosa and was composed of both adenocarcinomatous and sarcomatous components. Adenocarcinomatous foci generally showed tubular to solid patterns and occupied the parts facing the gastric lumen, while the sarcomatous components showed a generally irregular and solid arrangement. There were transitions between the sarcomatous and carcinoma elements. In addition, carcinoma cells with a cord-like or trabecular arrangement similar to that seen in endocrine carcinoma expressed chromogranin a, and were mainly observed in an intermediate area between the adenocarcinomatous and sarcomatous foci. The sarcomatous areas were mainly composed of spindle cells and occasionally contained a sarcomatous component showing rhabdomyosarcomatous differentiation. This is an interesting case to consider how the variety of cell type appeared in such a type of tumor in the stomach.- - - - - - - - - - ranking = 1keywords = endocrine (Clic here for more details about this article) |
2/389. Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids.BACKGROUND: Type 1 gastric carcinoids are associated with hypergastrinaemia and chronic atrophic gastritis, type 2 occur in patients with multiple endocrine neoplasia type 1 combined with zollinger-ellison syndrome, and type 3 lack any relation to hypergastrinaemia. Type 1 tumours are usually benign whereas type 3 are highly malignant. AIMS: To identify possible tumour markers in patients with gastric carcinoids. patients/METHOD: Nine patients with type 1, one with type 2, and five with type 3 were evaluated with regard to symptoms, hormone profile, and prognosis. RESULTS: plasma chromogranin a was increased in all patients but was higher (p < 0.01) in those with type 3 than those with type 1 carcinoids. All patients with type 3 carcinoids died from metastatic disease, but none of the type 1 patients died as a result of their tumours. One type 1 patient with a solitary liver metastasis received interferon alpha and octreotide treatment. Nine months later, the metastasis was no longer detectable. She is still alive eight years after diagnosis, without recurrent disease. This represents the only reported case of foregut carcinoid with an unresectable liver metastasis that seems to be have been cured by biotherapy. CONCLUSIONS: plasma chromogranin a appears to be a valuable tumour marker for all types of gastric carcinoid. Combination therapy with interferon alpha and octreotide may be beneficial in patients with metastasising type 1 gastric carcinoids.- - - - - - - - - - ranking = 4.1978660872537keywords = multiple endocrine, endocrine, endocrine neoplasia, multiple endocrine neoplasia, neoplasia (Clic here for more details about this article) |
3/389. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring.We present three cases of blastic mantle cell lymphoma with an unusual initial manifestation in Waldeyer's ring with methods for differentiating it from other blastic neoplasms of the head and neck. All cases presented with a feeling of fullness in the area of the mass. Morphologically, the tumours were blastic with a high mitotic rate (three to nine per high power field). All were B-cell phenotype with coexpression of CD43. In all cases cyclin d1 and bcl-2 were positive and CD23 negative. Blastic mantle cell lymphoma occurring in Waldeyer's tonsillar ring may be mistaken for other high grade haematopoietic neoplasms. immunohistochemistry and awareness of this type of lymphoma are helpful in differentiating it from other neoplasms.- - - - - - - - - - ranking = 0.66013793186981keywords = neoplasm (Clic here for more details about this article) |
4/389. Combined yolk sac tumor and adenocarcinoma in a gastric stump: molecular evidence of clonality.BACKGROUND: Extragonadal yolk sac tumors of the gastrointestinal tract are extremely rare neoplasms. Their greater rarity compared with other extragonadal yolk sac tumors suggests that different pathogenetic mechanisms could be involved according to the site of origin. This report describes a case of a combined yolk sac tumor and adenocarcinoma that arose in a gastric stump in a man age 61 years 43 years after he underwent distal gastric resection and gastrojejunostomy (Billroth II operation) for a benign duodenal ulcer. The coexistence of an adenocarcinomatous component with the yolk sac component suggests that the two histologic patterns may represent distinct phenotypes arising from a common mucosal epithelial cell. methods: Immunohistochemical and molecular techniques were used to define the mutation pattern of p53 in both components of the tumor. RESULTS: Single-strand conformation polymorphism and sequencing analyses demonstrated the same pattern of p53 mutation in the adenocarcinomatous and yolk sac tumor components. CONCLUSIONS: This finding suggests that the two tumors could have been derived from the same cellular clone and supports the hypothesis that the two components represented a heterogeneous differentiation of the same tumor.- - - - - - - - - - ranking = 0.22004597728994keywords = neoplasm (Clic here for more details about this article) |
5/389. Gastric carcinoma in association with remitting seronegative symmetrical synovitis with pitting edema.We describe an elderly woman who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE). In addition to typical findings, she had increased alkaline phosphatase; and investigations revealed metastatic gastric carcinoma. The literature relating to RS3PE in association with neoplasia is reviewed.- - - - - - - - - - ranking = 0.22824608625549keywords = neoplasia (Clic here for more details about this article) |
6/389. Gastric carcinoma with osteoclast-like giant cells.Extraskeletal neoplasms with osteoclast-like giant cells are uncommon. These tumors are most frequently reported in the breast and pancreas, and are relatively rare in other sites. We report a case of primary gastric adenocarcinoma with an infiltrate of osteoclast-like giant cells. The patient is a 64-yr-old black woman who presented with epigastric pain and was found to have a mass in the gastric antrum. Histological examination showed a poorly differentiated adenocarcinoma with an infiltrate of osteoclast-like giant cells. The giant cells were present both in the primary gastric adenocarcinoma and in the lymph node metastases. Immunohistochemical stains demonstrated that the giant cells were of monocytic/histiocytic origin and probably represent a distinctive host response to the tumor. The patient is alive and well 12 months after resection. This is the second published report of gastric carcinoma with osteoclast-like giant cells. Based on this limited experience, gastric carcinoma with osteoclast-like giant cells may represent a distinct clinicopathological entity with a more favorable prognosis.- - - - - - - - - - ranking = 0.22004597728994keywords = neoplasm (Clic here for more details about this article) |
7/389. Natural killer-like T-cell lymphoma of the stomach.We report the case of a 69-year-old white woman who developed a natural killer (NK)-like T-cell lymphoma involving primarily the stomach. The tumour consisted of large and pleomorphic lymphocytes infiltrating the gastric mucosa. immunohistochemistry performed on paraffin sections showed the neoplastic cells to be CD3 , CD5-, CD8-, CD43 , CD45RO , and CD57 . In addition, these cells also expressed HLA-DR, granzyme B, and, to a lesser extent, the CD30 activation marker. No pathologic features suggesting helicobacter pylori, Epstein-Barr virus infection, or lymphocytic gastritis were found within adjacent normal mucosa. The patient had no previous history of coeliac disease, and her serology for H. pylori was negative. Since lymphomas are usually considered the neoplastic counterpart of normal lymphocytic subsets, it is possible that in this case the tumour cells originate from a distinct cytotoxic T-cell population normally present within the gastric mucosa. The pathogenesis of this highly unusual neoplasm, however, remains a mystery.- - - - - - - - - - ranking = 0.22004597728994keywords = neoplasm (Clic here for more details about this article) |
8/389. Intrahepatic cholangiocarcinoma with extensive sarcomatous change: report of a case.A 77-year-old woman was admitted to our hospital with severe upper abdominal pain. ultrasonography showed a well-defined hypoechoic mass with heterogeneity in the left lobe of the liver, and computed tomography demonstrated a low-density mass with enhanced peripheral areas. magnetic resonance imaging revealed a mass with iso- to low signal intensity on T1-weighted images (WI) and heterogeneous high and low signal intensity on T2 WI. The tumor was found to be hypovascular by angiography. During 5 months of observation, the tumor increased in size, which strongly suggested malignancy. A laparotomy was performed under the provisional diagnosis of a neoplasm other than hepatocellular carcinoma, revealing that the hepatic mass had invaded the gastric wall. Therefore, a left hepatic lobectomy with dissection of the lymph nodes and hemigastrectomy was carried out. Histologically, the tumor was found to be composed of a large amount of sarcomatous elements and a small amount of adenocarcinomatous elements, both of which were partly intermingled. Immunohistochemically, the sarcomatous element demonstrated the features of malignant fibrous histiocytoma (MFH). Thus, a diagnosis of intrahepatic cholangiocarcinoma with MFH-like sarcomatous change was confirmed.- - - - - - - - - - ranking = 0.22004597728994keywords = neoplasm (Clic here for more details about this article) |
9/389. CEA-producing mucin-negative gastric signet-ring cell carcinoma with neuroendocrine markers: a case report.biopsy and autopsy materials excised from a 69-year-old woman were investigated. serum carcinoembryonic antigen (CEA) showed a high value of 955 ng/mL. A plateaulike tumor was located in the gastric cardia and fundus to the entire gastric body. It showed severe proliferation and infiltration from the mucosa to the serosa. The tumor was comprised of signet-ring cells and poorly differentiated adenocarcinoma cells, which spread into the submucosa of the pylorus, duodenum, and jejunum. Signet-ring cells had a large, eccentric vesicular nucleus and a pale cytoplasmic inclusion. Poorly differentiated adenocarcinoma cells had a pleomorphic nucleus, small eosinophilic nucleolus, and abundant eosinophilic cytoplasm. Both neoplastic cells were positive for CEA, epithelial membrane antigen, Leu-7 (CD57), and neuron-specific enolase, and were negative for cytokeratin, vimentin, and periodic acid-Schiff, alcian blue, and mucicarmine stains. Electron microscopy showed endocrine granules with a limiting membrane measuring approximately 238 nm in diameter in the cytoplasm. The authors diagnosed this patient as having mucin-negative gastric signet-ring cell carcinoma with neuroendocrine markers, which is suggested to exist among poorly differentiated adenocarcinoma, undifferentiated carcinoma, and signet-ring cell carcinoma.- - - - - - - - - - ranking = 6keywords = endocrine (Clic here for more details about this article) |
10/389. 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 = 0.22004597728994keywords = neoplasm (Clic here for more details about this article) |
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