scholarly journals A Gastric Intramucosal Mixed Adenocarcinoma-Neuroendocrine Tumor

2021 ◽  
pp. 323-331
Author(s):  
Yoshifumi Sano ◽  
Shoichi Saito ◽  
Hiroshi Kawachi ◽  
Jun Tsutsumi ◽  
Junko Fujisaki
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumor ◽  
Acute Cholecystitis ◽  
Endocrine Cell ◽  
Chromogranin A ◽  
Tubular Adenocarcinoma ◽  
Histological Findings ◽  
Cell Hyperplasia ◽  
Well Differentiated ◽  
Adenocarcinoma Component

Gastric mixed adenocarcinoma-neuroendocrine tumor (NET) is a rare composite tumor, and a limited number of studies have reported on it. A 77-year-old man was admitted to our hospital because of acute cholecystitis. He underwent a cholecystectomy. Esophagogastroduodenoscopy during his admission revealed a slightly elevated tumor, and biopsy demonstrated a well-differentiated tubular adenocarcinoma. The tumor was resected completely by endoscopic submucosal dissection. Histological findings showed that it measured 9 mm in diameter, was located within the mucosa, and consisted of well-differentiated tubular adenocarcinoma and a NET G1. The NET was covered with adenocarcinoma and both components exhibited histological continuity. The NET and a part of the adenocarcinoma component showed a positive reaction for chromogranin A and synaptophysin. Neither enterochromaffin-like cell hyperplasia nor endocrine cell micronest surrounded the tumor. The diagnosis was gastric mixed adenocarcinoma-NET. The histological continuity between the two components can be likened to the same histogenesis.

scholarly journals Gastric neuroendocrine tumor treated with endoscopic submucosal dissection

2016 ◽  
Vol 29 (4) ◽  
pp. 176-179
Author(s):  
Pawel Bojar ◽  
Jaroslaw Swatek ◽  
Jaroslaw Drabko ◽  
Katarzyna Golec ◽  
Anna Ostrowska ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumor ◽  
Effective Treatment ◽  
Male Patient ◽  
Microscopic Examination ◽  
Chromogranin A ◽  
Primary Diagnosis ◽  
Biopsy Sample ◽  
Submucosal Dissection ◽  
Proper Diagnosis

Abstract A case of a 59-year-old male patient with gastric neuroendocrine tumor which was misdiagnosed as adenocarcinoma, is presented. Herein, primary diagnosis was made due to the similarity of endoscopic pictures of both diseases and dues to the inappropriate interpretation of a small biopsy sample. The patient was qualified for endoscopic submucosal dissection. Microscopic examination of whole lesion, supplemented by immmunohistochemical reactions (chromogranin A, synaptophysin, cytokeratins 7 and 20, Ki67) revealed gastric neuroendocrine tumor (NET) G2. The lesson learnt is that to provide effective treatment to the patient, it is necessary to use all available methods to make a proper diagnosis and to distinguish the suspected disease from others with similar features.

scholarly journals A case of mixed-type early gastric cancer with recurrence following curative endoscopic submucosal dissection for expanded indication

2019 ◽  
Vol 07 (06) ◽  
pp. E841-E845
Author(s):  
Shunsuke Kobayashi ◽  
Satoru Nonaka ◽  
Ichiro Oda ◽  
Seiichiro Abe ◽  
Haruhisa Suzuki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Lymphovascular Invasion ◽  
Treatment Guidelines ◽  
Distant Recurrence ◽  
Tubular Adenocarcinoma ◽  
Tumor Diameter ◽  
Submucosal Dissection ◽  
Well Differentiated

Abstract Background and study aims In Japan, intramucosal gastric adenocarcinoma with ulcerative finding having a predominantly differentiated type with an undifferentiated component, tumor diameter ≤ 3 cm, and no lymphovascular invasion is included in the expanded pathological criteria for curative endoscopic treatment. This indication is based on retrospective examination of surgical resection cases, and is determined to have a negligible risk of lymph node metastasis (LNM). We performed endoscopic submucosal dissection on a 78-year-old man with early gastric cancer in 2011, and pathology revealed a well-differentiated tubular adenocarcinoma (21 × 10 mm in diameter), with poorly differentiated adenocarcinoma components, limited to the mucosa, fibrosis by ulcer scar in the submucosal layer, no lymphovascular invasion, and tumor-free margins. Resection was determined to be curative under expanded indications of the gastric cancer treatment guidelines, 4th edition. However, 55 months after the initial diagnosis, invasive local and distant recurrence was noted. Ultimately, the patient died of gastric cancer 3 months after recurrence.

Endoscopic submucosal dissection by using Clutch cutter and IT knife 2 for early gastric cancer with severe submucosal fibrosis: a case report

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 17-21
Author(s):  
Nhan Le ◽  
Phuong Vien ◽  
Nghia Le
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastrointestinal Cancers ◽  
Pathological Result ◽  
Well Differentiated ◽  
Submucosal Fibrosis

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis. Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence. Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

HER2 OVEREXPRESSION IN ENDOSCOPIC BIOPSY SAMPLE OF GASTRIC ADENOCARCINOMA BY IMMUNOHISTOCHEMISTRY

2012 ◽  
pp. 109-118
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta
Keyword(s):  
Gastric Adenocarcinoma ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Endoscopic Biopsy ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Well Differentiated

Background and aim: HER2 overexpression by immunohistochemistry is a prognostic maker in gastric cancer and helps to select candidates benefitted from targeted therapy with trastuzumab. This study is aimed at the assessing HER2 overexpression and its relationship with endoscopic and histopathological findings of gastric adenocarcinoma. Objectives and methods: Biopsy samples from 92 gastric cancer patients were examined for HER2 status by immunohistochemical staining. Results: 6.5% of tumors were cardia tumors and 93.5% were non-cardia tumors. Using the Lauren classification, 51.1% were intestinal type and 48.9% were diffuse type. Using WHO classification, 54.3% were tubular adenocarcinoma, 7.6% were mucinous adenocarcinoma, 15.2% were signet-ring cell carcinoma, and 22.8% were undifferentiated carcinoma. 32.6% were well-differentiated, 15.2% were moderately-differentiated, and 52.2% were poorly-differentiated carcinoma. HER2 was positive in 20.7% of gastric carcinomas, 50% cardia tumors and 18.6% non-cardia tumors. HER2 positivity among polypoid, fungating, ulcerated, and infiltrative types were 38.5%, 29.7%, 9.1% and 0%, respectively. HER2 overexpression in intestinal type was higher than that in diffuse type (31.9% vs. 8.9%, p = 0.009). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 28.0%, 14.3%, 7.1% and 14.3%, respectively. HER2 overexpressions were different between differentiation degrees: 30% of well-differentiated tumors, 35.7% moderately-differentiated tumors, and 10.4% of poorly-differentiated tumors (p = 0.037). Conclusions: HER2 overexpression was found in 20.7% of endoscopic biopsy sample of gastric adenocarcinoma and was associated with endoscopic gross characteristic, Lauren histologic type and differentiation degree.

Rectal Calcified Fibrous Tumor Diagnosed After Endoscopic Submucosal Dissection of a Suspected Neuroendocrine Tumor

2016 ◽  
Vol 111 (6) ◽  
pp. 764
Author(s):  
João Santos-Antunes ◽  
Margarida Marques ◽  
Patrícia Andrade ◽  
Filipe Vilas-Boas ◽  
Andreia Albuquerque ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumor ◽  
Submucosal Dissection ◽  
Fibrous Tumor

scholarly journals Molecular Pathology of Well-Differentiated Pulmonary and Thymic Neuroendocrine Tumors: What Do Pathologists Need to Know?

2021 ◽  
Vol 32 (1) ◽  
pp. 154-168 ◽  
Author(s):  
Marco Volante ◽  
Ozgur Mete ◽  
Giuseppe Pelosi ◽  
Anja C. Roden ◽  
Ernst Jan M. Speel ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Young Patients ◽  
Carcinoid Tumors ◽  
Neuroendocrine Neoplasms ◽  
Grey Zone ◽  
Cell Hyperplasia ◽  
Ki 67 ◽  
Familial Form ◽  
Well Differentiated ◽  
Neuroendocrine Carcinomas

AbstractThoracic (pulmonary and thymic) neuroendocrine tumors are well-differentiated epithelial neuroendocrine neoplasms that are classified into typical and atypical carcinoid tumors based on mitotic index cut offs and presence or absence of necrosis. This classification scheme is of great prognostic value but designed for surgical specimens, only. Deep molecular characterization of thoracic neuroendocrine tumors highlighted their difference with neuroendocrine carcinomas. Neuroendocrine tumors of the lung are characterized by a low mutational burden, and a high prevalence of mutations in chromatin remodeling and histone modification-related genes, whereas mutations in genes frequently altered in neuroendocrine carcinomas are rare. Molecular profiling divided thymic neuroendocrine tumors into three clusters with distinct clinical outcomes and characterized by a different average of copy number instability. Moreover, integrated histopathological, molecular and clinical evidence supports the existence of a grey zone category between neuroendocrine tumors (carcinoid tumors) and neuroendocrine carcinomas. Indeed, cases with well differentiated morphology but mitotic/Ki-67 indexes close to neuroendocrine carcinomas have been increasingly recognized. These are characterized by specific molecular profiles and have an aggressive clinical behavior. Finally, thoracic neuroendocrine tumors may arise in the background of genetic susceptibility, being MEN1 syndrome the well-defined familial form. However, pathologists should be aware of rarer germline variants that are associated with the concurrence of neuroendocrine tumors of the lung or their precursors (such as DIPNECH) with other neoplasms, including but not limited to breast carcinomas. Therefore, genetic counseling for all young patients with thoracic neuroendocrine neoplasia and/or any patient with pathological evidence of neuroendocrine cell hyperplasia-to-neoplasia progression sequence or multifocal disease should be considered.

Sign in / Sign up

Export Citation Format

Share Document