PMC539240_01
Histomorphologic appearance of the primary gastric carcinoma (A) and a paragastric lymph node metastasis (B). Photomicrograph shows that the primary tumor is mainly composed of solid and tubular formations, whereas, a marked desmoplastic stromal reaction is seen in the lymph node metastasis. (hematoxylin and eosin x 40).
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F1
Microscopically, the carcinoma was mainly composed of tubular formations of mitotically active, atypical epithelial cells (Figure 1A). The latter two were mainly observed in paragastric lymph node metastases (Figure 1B).
Computed tomography of the abdomen four years after Billroth II resection for gastric cancer, revealing an inhomogenous mass in the pancreatic head, 4 cm in diameter. (Picture courtesy the Division of Radiology, German Cancer Research Center, provided by PD Dr. med. S. Delorme).
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F2
Four years after gastric resection, however, ultrasound examination, computed tomography and magnetic resonance imaging revealed an inhomogeneous mass of the pancreatic head, measuring 4 cm in largest diameter (Figure 2).
Histomorphologic appearance of the delayed pancreatic metastasis (hematoxylin and eosin x 100). As in the lymph node metastasis, a marked desmoplastic stromal reaction is seen in the pancreatic metastasis.
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F3
Microscopically, the tumor consisted of solid and glandular formations of atypical epithelial cells with distinct nuclear pleomorphism and presented marked desmoplastic stromal reaction, as well as areas of necrosis (Figure 3).