PMC6136504_01
Gastroscopy revealed a 10-mm superficial elevated lesion with a slight central depression (type 0-IIa+IIc).
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Gastroscopy revealed a 10-mm diameter, superficial elevated lesion with a slight central depression (type 0-IIa+IIc; Figure 1) at anterior wall of lower gastric body.
Gross findings of the formalin-fixed endoscopically resected specimen. The tumor was 10 x 8 mm in size, well-circumscribed, and accompanied by hemorrhage.
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Macroscopically, the tumor was 10 x 8 mm in size, well-circumscribed, and accompanied by hemorrhage (Figure 2).
Low-magnification microscopic findings. Note the invasion of the submucosal layer.
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Low-magnification microscopy confirmed the invasion of the submucosal layer (Figure 3), whereas at high-magnification microscopy revealed cuboidal tumor cells with round to irregular-shaped nuclei, a prominent nucleolus, and clear cytoplasm characteristic of GCED (Figure 4(a)).
High-magnification microscopic findings. (a) Cuboidal tumor cells with round to irregular-shaped nuclei, prominent nucleoli, and the characteristically clear cytoplasm. Hematoxylin-Eosin (HE) stain. (b) The tumor growth pattern was predominantly solid and trabecular. HE stain. (c) Some tubular growth formation was identified. HE stain. (d) Alcian blue and periodic acid-Schiff stain of the specimen, demonstrating abundant glycogen in the cytoplasm.
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Low-magnification microscopy confirmed the invasion of the submucosal layer (Figure 3), whereas at high-magnification microscopy revealed cuboidal tumor cells with round to irregular-shaped nuclei, a prominent nucleolus, and clear cytoplasm characteristic of GCED (Figure 4(a)). A predominantly solid and trabecular growth pattern with a small proportion of tubular formation was also identified (Figures 4(b) and 4(c)). Further findings included conspicuous stromal hemorrhage, abundant cytoplasmic glycogen (according to Alcian blue and periodic acid-Schiff staining (Figure 4(d))), absence of mucin, and lymphovascular invasion.
Immunohistochemical findings. The tumor cells were positive for the enteroblastic lineage biomarkers (a) AFP, (b) GPC3, and (c) SALL4.
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