PMC5587894_01
(A) EGD before chemotherapy revealed Borrmann type 3 cancer in the lesser curvature of the stomach. Histological examination of the biopsy showed poorly differentiated adenocarcinoma. (B) EGD after chemotherapy showed a scar-like flat lesion in the lesser curvature of the stomach. Cancer cells were not found in the biopsy specimen.
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Esophagogastroduodenoscopy (EGD) indicated the presence of a Borrmann type 3 tumor in the lesser curvature of the stomach (Fig. 1A), and histological biopsy specimens showed poorly differentiated adenocarcinoma. EGD after chemotherapy demonstrated that the gastric lesion was scarred (Fig. 1B).
Abdominal enhanced CT before chemotherapy demonstrated (A) bulky lymph nodes along the celiac artery (No.9 [33 mm]) and the lesser curvature (No.3 [42 mm]). (B) Paraaortic lymph nodes (No.16a2) were swollen (27 mm). CT after chemotherapy revealed (C) that No.9 disappeared and that No.3 shrunk. (D) No.16a2 was also reduced in size.
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Lymph nodes along the celiac artery and the lesser curvature were remarkably swollen (i.e., bulky N2) (Fig. 2A). Metastasis to PAN (No. 16a2) was also observed (Fig. 2B). Additionally, abdominal CT revealed a reduction in the size of the regional lymph nodes (Fig. 2C), especially the PAN (Fig. 2D); this was considered an indication for surgery.
Macroscopic findings of the resected specimen revealed a scar-like lesion in the lesser curvature of the stomach. One tick mark = one mm.
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Macroscopically, the gastric lesion in the resected specimen was scarred (Fig. 3).