PMC102757_01
(A) Scanning electron microphotograph of gastric mucosa at presentation showing multiple round cells (possibly lymphocytes) but No H. pylori (x 1000). (B) Scanning electron microphotograph of gastric mucosa during re-infection showing bacillus with polar flagella suggestive of H. pylori (x 8000).
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F1
S530, Japan) from biopsies obtained from relatively normal looking areas revealed multiple round cells (might be lymphocytes, figure 1A) but no H. pylori. Serum titer for IgG antibody against H. pylori using ELISA based commercially available kit (Monobind Incorporation, California) was positive (21 IU/ml). H. pylori (figure 1B). Histopathology of biopsy from margin of ulcers revealed multiple signet ring cells, cellular pleomorphism, mucin secretion, abnormal mitotic figures and gland formation at certain places (figure 2B).
(A) Resected specimen of distal stomach showing diffuse infiltration by mononuclear cells without formation of lymphoid follicles with obvious cellular atypia and abnormal mitotic figures (H&E x 275). (B) The high power view of recurrent gastric tumor showing pleomorphic cells, abnormal mitotic figures, mucin secretion and formation of gland at places diagnostic of adenocarcinoma (H&E x 275).
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F2
Histological examination of resected specimen revealed transmural infiltration by mononuclear cells diffusely extending through muscularis mucosa into the submucosa without formation of lymphoid follicles, cellular atypia, abnormal mitotic figures (figure 2A) and lymphoepithelial lesions. H. pylori (figure 1B). Histopathology of biopsy from margin of ulcers revealed multiple signet ring cells, cellular pleomorphism, mucin secretion, abnormal mitotic figures and gland formation at certain places (figure 2B).
Flow cytometry was performed using FACS calibur (Becton Dickinson) and data were analyzed using Cell Quest program. One parameter histogram is shown.
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F3
Flow cytometry by standard technique from these biopsies using anti-CD 19 (B cell marker) and anti-CD3 (T cell marker) monoclonal antibodies revealed polyclonal infiltrate with 6.6% CD 19 and 10.8% CD3 bearing cells (figure 3). Since a possibility of recurrent PGL was considered, flow cytometry was done by standard technique with biopsy from the tumor using anti-CD 19 (B cell marker) and anti-CD3 (T cell marker) antibodies; it revealed a polyclonal lymphocytic infiltrate consisting of 0.9% CD 19 and 3.9% CD3 bearing cells (figure 3).