PMC5508625_01
Upper gastrointestinal endoscopy showing a friable gastric tumor with necrosis in the gastric cardia and extending to the abdominal esophagus.
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Upper gastrointestinal endoscopy revealed a friable gastric tumor with necrosis in the gastric cardia extending to the abdominal esophagus (Fig. 1).
(a) Microscopic evaluation of biopsy specimens showing solid growth of small cells with hyperchromatic nuclei and scant cytoplasm. (b)-(e) Immunohistochemical staining showing cancer cells stained positive for chromogranin A (b) and synaptophysin (c) and negative for cluster of differentiation 56 (d) and neuron-specific enolase (e) in the cytoplasm.
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Microscopic examination of the endoscopic biopsy specimens showed solid growth of small cells with hyperchromatic nuclei and scant cytoplasm (Fig. 2a). Positive staining for chromogranin A and synaptophysin and negative staining for CD56 and NSE in the cytoplasm of cancer cells were noted, and a diagnosis of small cell carcinoma was established (Fig. 2b-e).
Resected tumor with accompanying necrosis and hemorrhage. Size, 90 x 75 mm.
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Size of the resected tumor was 90 x 75 mm, and it was accompanied by necrosis and hemorrhage (Fig. 3).
(a) Hematoxylin-eosin staining revealing that the hemorrhagic and necrotic areas were composed of two histological types: cytotrophoblastic cells with single oval nuclei (black arrow) and syncytiotrophoblastic cells with multiple bizarre nuclei (red arrow). (b) Immunohistochemical staining revealing that the tumor cells stained positive for anti-human chorionic gonadotropin antibody.
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Microscopic evaluation following hematoxylin-eosin staining showed that the hemorrhagic and necrotic areas showed two histological types: cytotrophoblastic cells with single oval nuclei and syncytiotrophoblastic cells with multiple bizarre nuclei (Fig. 4a). Immunohistochemical staining revealed that the tumor stained positive for anti-human chorionic gonadotropin (hCG) antibody, but negative for chromogranin A and synaptophysin (Fig. 4b).
The tumor was predominantly composed of two distinct components: choriocarcinoma (black arrow) and small cell carcinoma (red arrow), with a clear point of collision.
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The tumor was thus predominantly composed of two distinct components: choriocarcinoma and small cell carcinoma, with a clear point of collision (Fig. 5); the adenocarcinoma component was minor.