A Case of Tubular Adenocarcinoma Arising from Ectopic Pancreas in the Stomach

On the basis of light microscopic observation, the ultrastructural localization of CEA in gastric cancer was studied by immunoelectron microscopic technique. The distribution of CEA in gastric cancer and its biological significance and the mechanism of abnormal distribution of CEA were further discussed.Among 104 surgically resected specimens of gastric cancer with PAP method at light microscopic level, the incidence of CEA(+) was 85.58%. All of mucinous carcinoma exhibited CEA(+). In tubular adenocarcinoma the incidence of CEA(+) showed a tendency to rising with the increase of degree of differentiation. In normal epithelia and intestinal metaplasia CEA was faintly present and was found only in the luminal surface. The CEA staining patterns in cancer cells were of three types--- cytoplasmic, membranous and weak reactive type. The ultrastructural localization of CEA in 14 cases of gastric cancer was studied by immunoelectron microscopic technique.There was a little or no CEA in the microvilli of normal epithelia. In intestinal metaplasia CEA was found on the microvilli of absorptive cells and among the mucus particles of goblet cells. In gastric cancer CEA was also distributed on the lateral and basal surface or even over the entire surface of cancer cells and lost their polarity completely. Many studies had proved that the alterations in surface glycoprotein were characteristic changes of tumor cells. The antigenic determinant of CEA was glycoprotein, so the alterations of tumor-associated surface glycoprotein opened up a new way for the diagnosis of tumors.

Download Full-text

Esophageal Adenocarcinoma with Enteroblastic Differentiation Arising in Ectopic Gastric Mucosa in the Cervical Esophagus: a Case Report and Literature Review

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.262.gus ◽

2017 ◽

Vol 26 (2) ◽

pp. 193-197 ◽

Cited By ~ 3

Author(s):

Ryosuke Gushima ◽

Rei Narita ◽

Takashi Shono ◽

Hideaki Naoe ◽

Takashi Yao ◽

...

Keyword(s):

Gastric Mucosa ◽

Esophageal Adenocarcinoma ◽

Histopathological Examination ◽

Narrow Band Imaging ◽

Carbohydrate Antigen ◽

Endoscopic Examination ◽

Ectopic Gastric Mucosa ◽

Tubular Adenocarcinoma ◽

Positron Emission ◽

Elevated Lesion

Background: Adenocarcinoma with enteroblastic differentiation is a subtype of alpha-fetoprotein (AFP) producing adenocarcinoma. This type of tumor is associated with a poor prognosis and is prone to metastasize. Esophageal adenocarcinoma with enteroblastic differentiation is extremely rare.Case presentation: The patient was a 65-year-old woman who was referred to our hospital with dysphagia. Endoscopic examination revealed an elevated lesion 20mm in diameter at 17cm from the upper incisors. Endoscopic submucosa dissection (ESD) was performed and histopathological examination revealed tubular adenocarcinoma composed of cuboidal cells with clear cell cytoplasm. Immunohistochemical stain was diffusely positive for Sall-like protein 4 (SALL4) and weakly positive for AFP and glypican 3. From this result, we diagnosed esophageal adenocarcinoma with enteroblastic differentiation. The patient is still alive without recurrence of cancer 40 months after ESD.Conclusion: To our knowledge, this is the first report to undergo ESD for esophageal adenocarcinoma with enteroblastic differentiation arising from ectopic gastric mucosa in the esophagus.Abbreviations: AFP: alfa-fetoprotein; CA19-9: carbohydrate antigen 19-9; CEA: carcinoembryonic antigen; ESD: endoscopic submucosal dissection; EUS: endoscopic ultrasound; FDG-PET: [18F] fluorodeoxyglucose positron emission tomography; ME: magnifying endoscopy; NBI: narrow band imaging; SALL 4: Sall-like protein 4; SCC: squamous cell carcinoma antigen.

Download Full-text

HER2 OVEREXPRESSION IN ENDOSCOPIC BIOPSY SAMPLE OF GASTRIC ADENOCARCINOMA BY IMMUNOHISTOCHEMISTRY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.5.14 ◽

2012 ◽

pp. 109-118

Author(s):

Viet Nho Le ◽

Van Huy Tran ◽

Cong Thuan Dang ◽

Van To Ta

Keyword(s):

Gastric Adenocarcinoma ◽

Undifferentiated Carcinoma ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Endoscopic Biopsy ◽

Her2 Overexpression ◽

Tubular Adenocarcinoma ◽

Signet Ring ◽

Poorly Differentiated ◽

Well Differentiated

Background and aim: HER2 overexpression by immunohistochemistry is a prognostic maker in gastric cancer and helps to select candidates benefitted from targeted therapy with trastuzumab. This study is aimed at the assessing HER2 overexpression and its relationship with endoscopic and histopathological findings of gastric adenocarcinoma. Objectives and methods: Biopsy samples from 92 gastric cancer patients were examined for HER2 status by immunohistochemical staining. Results: 6.5% of tumors were cardia tumors and 93.5% were non-cardia tumors. Using the Lauren classification, 51.1% were intestinal type and 48.9% were diffuse type. Using WHO classification, 54.3% were tubular adenocarcinoma, 7.6% were mucinous adenocarcinoma, 15.2% were signet-ring cell carcinoma, and 22.8% were undifferentiated carcinoma. 32.6% were well-differentiated, 15.2% were moderately-differentiated, and 52.2% were poorly-differentiated carcinoma. HER2 was positive in 20.7% of gastric carcinomas, 50% cardia tumors and 18.6% non-cardia tumors. HER2 positivity among polypoid, fungating, ulcerated, and infiltrative types were 38.5%, 29.7%, 9.1% and 0%, respectively. HER2 overexpression in intestinal type was higher than that in diffuse type (31.9% vs. 8.9%, p = 0.009). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 28.0%, 14.3%, 7.1% and 14.3%, respectively. HER2 overexpressions were different between differentiation degrees: 30% of well-differentiated tumors, 35.7% moderately-differentiated tumors, and 10.4% of poorly-differentiated tumors (p = 0.037). Conclusions: HER2 overexpression was found in 20.7% of endoscopic biopsy sample of gastric adenocarcinoma and was associated with endoscopic gross characteristic, Lauren histologic type and differentiation degree.

Download Full-text