PMC2779310_01
Gastroendoscopy shows a geographic mucosal irregularity at the antrum (A). Endoscopic ultrasonography shows submucosal thickening of the stomach (arrows) (B).
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F1
Gastroendoscopic examination revealed a geographic mucosal irregularity at the antrum (Fig. 1A), and we performed a biopsy at the site. Endoscopic ultrasonography showed the mucosal thickening (Fig. 1B), and the computerized tomography scan of the abdomen showed no evidence of distant metastasis.
A macroscopic picture of the total gastrectomy specimen. The ulceroinfiltrative mass measuring 8x4.5 cm can be seen on the lesser curvature of the antrum.
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F2
The gross finding of the resected stomach tissue revealed an 8x4.5 cm well-demarcated ulceroinfiltrative lesion at the pyloric antrum along the lesser curvature (Fig. 2), which infiltrated into the submucosal layer.
Histologic and immunohistochemical pictures of the gastric tumor. A high power view (H&E, x400) shows a diffuse and solid proliferation of large atypical cells with pleomorphic nuclei. Multiple nuclear lobulations are noted (A). Positive immunoreactivity with anti-CD30 (x400) and (B), negative immunoreactivity for ALK (x400) (C).
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F3
Some giant tumor cells were confined in the mucosa-submucosa area, and they showed multiple nuclear lobulations (Fig. 3A). The tumor cells were positive for CD30 (Fig. 3B), vimentin and CD3, but they were negative for cytokeratin, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), CD45, CD20, CD45RO and anaplastic lymphoma kinase (ALK) (Fig. 3C).