PMC3304076_01
a Endoscopic examination of the upper gastrointestinal tract revealed a 2-cm tumor, with a deep central depression, surrounded by a smooth elevated area, in the middle of the stomach body. b Ultrasound endoscopic examination showed that the tumor invaded the subserosa.
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F1
A biopsy showed that the tumor was a moderately differentiated gastric adenocarcinoma (fig. 1a). Ultrasound endoscopic examination showed that the tumor invaded the subserosa (fig. 1b).
a Gross pathological examination showed that the tumor was a 3.5 x 2.5 cm type 2 lesion in the middle of the posterior wall of the stomach body. b At microscopic examination the tumor comprised two elements at the histological level (hematoxylin-eosin staining, x2): (i) A moderately differentiated adenocarcinoma in the superficial portion of the mucous membrane layer (x40). (ii) NEC-like cells with dark, round nuclei and scant cytoplasm, presenting a solid and trabecular pattern, in the submucosal and muscularis propria layers (x40).
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F2
Gross pathological examination showed that the tumor was a 3.5 x 2.5 cm type 2 lesion in the middle of the posterior wall of the stomach body (fig. 2a). Hematoxylin-eosin staining showed that the tumor comprised two elements at the histological level: (i) a moderately differentiated adenocarcinoma in the superficial portion of the mucous membrane layer, and (ii) NEC-like cells with dark, round nuclei and scant cytoplasm, presenting a solid and trabecular pattern, in the submucosal and muscularis propria layers (fig. 2b).
Immunohistochemical findings (x40). The NEC-like cells were diffusely positive for chromogranin A (a), synaptophysin (b), NCAM (d) and NSE (e), but were negative for CEA (c). The Ki-67 labeling index (f) was 95%.
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F3
The Ki-67 labeling index was 95% (fig. 3).