PMC5925204_01
Enlarged prepyloric folds with luminal narrowing.
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fig1
A repeat EGD revealed diffusely hypertrophied gastric folds, most prominent in the gastric antrum, with luminal narrowing of the pylorus (Figure 1).
Thickened gastric muscularis propria layer on endoscopic ultrasound.
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fig2
Further investigation with endoscopic ultrasound (EUS) showed marked concentric thickening of the muscularis propria in the gastric antrum (Figure 2) and fine needle biopsy (FNB) was performed with a 22-gauge Acquire  EUS FNB needle.
Hematoxylin and eosin (H&E) stain of FNA from gastric antrum showing tumor cells admixed with large pink bundles of muscle.
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fig3
Histology revealed infiltration of the gastric muscular wall by discohesive pleomorphic cells (Figure 3), positive for GATA3 (Figure 4) and negative for CDX2 (Figure 5) on immunohistochemistry, compatible with metastatic lobular breast carcinoma.
Immunohistochemical stain for GATA3, a lineage marker for breast origin.
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fig4
Histology revealed infiltration of the gastric muscular wall by discohesive pleomorphic cells (Figure 3), positive for GATA3 (Figure 4) and negative for CDX2 (Figure 5) on immunohistochemistry, compatible with metastatic lobular breast carcinoma.
Immunohistochemical stain for CDX-2, a marker of gastrointestinal differentiation.
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fig5
Histology revealed infiltration of the gastric muscular wall by discohesive pleomorphic cells (Figure 3), positive for GATA3 (Figure 4) and negative for CDX2 (Figure 5) on immunohistochemistry, compatible with metastatic lobular breast carcinoma.