PMC2892686_01
Large nodular hepatic flexure lesions as seen on Colonoscopy.
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fig1
Upper and lower endoscopy were performed which revealed multiple areas of nodular thickening involving the gastric antrum proximal duodenum and the hepatic flexure of the colon (Figure 1).
(a) Histopathology of biopsies taken from gastric lesions showing infiltrating adenocarcinoma with signet ring cell morphology (Arrow). (b) Immunohistochemistry of (a) showing positive ER.
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fig2
Biopsies showed infiltrating adenocarcinoma with signet ring cell morphology suspicious for primary gastric tumor (Figure 2(a)). However, Immunoperoxidase stain of the specimen revealed cytokeratin (CK) 7 and ER both were positive (Figure 2(b)) while CK-20 and CDX2 were negative suggestive of metastatic breast carcinoma.