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Gastric adenocarcinoma of fundic gland type with signet-ring cell carcinoma component: A case report and review of the literature

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World Journal of Gastroenterology 2018年第26期24卷 2915-2920页

作者： Keita Kai Masaaki Satake Osamu Tokunaga Department of Pathology Saga University Hospital Department of Gastroenterology Koga Hospital 21 Department of Pathology Shin Koga Hospital

A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy. Four years prior, she was diagnosed with a Helicobacter pylori infection but no eradication was performed. The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma. Endoscopic submucosal dissection(ESD) was performed. Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae. These tumor cells expressed focally pepsinogen-Ⅰ, diffusely MUC6, and scattered H^+/K^+ ATPase according to immunohistochemistry. Therefore, we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG). Adjacent to the GA-FG, proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed. Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma. To the best of our knowledge, this is the first case report of GA-FG with a signet-ring cell carcinoma component. The origin of signet-ring cell carcinoma, i.e., whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present. We expect the accumulation of similar cases and further analysis to clarify this issue.

关键词： Gastric adenocarcinoma of fundic gland type Endoscopic submucosal dissection Helicobacter pylori Intestinal metaplasia signet-ring cell carcinoma

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主要胃的图章戒指房间癌作为心脏的 tamponade 介绍

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World Journal of Gastrointestinal Oncology 2011年第4期3卷 67-70页

作者： Jun-Yan Huang Hai-Ping Jiang Dan Chen Han-Lin Tang Department of General Surgery The First Affiliated Hospital of Jinan UniversityWest No.613Huangpu RoadGuangzhou 510630Guangdong ProvinceChina Department of General Surgery The First Affiliated Hospital of Guang Dong Pharmaceutical UniversityNo.19 Nonglinxia RoadYuexiu DistrictGuangzhou 510080Guangdong ProvinceChina

Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early.Patients are generally asymptomatic until the disease is advanced.General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion.We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms.A 49-year old woman was admitted because of progressive dyspnea and cough.Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion.Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found,establishing the diagnosis of cardiac tamponade.Pericardiocentesis was performed and 420 mL of bloody fluid was taken.The patient died of respiratory failure and cardiac arrest on October 28,2009.Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature.The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.

关键词： Cardiac tamponade Gastric signet-ring cell carcinoma Pericarditis Pericardial effusion

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