Patient 54 yo with persistent epigastric
pain. Endoscopy showed an irregular suspicious angular area. Biopsy:
Signet ring cell
carcinoma. Gastrectomy performed.
opened along the greater curvature.
Close-up on the angular
region, showing a ill defined flatened mucosae, with irregular depressed
Low power panoramic
view of the antrum, showing mainly a preserved muscularis mucosae.
Closer views on the
mucosae, demonstrate atrophy of the glands and an infiltrate of
High power of previous
fields: the infiltrate is formed by Signet Ring Cells (SRC)
Low power PAS stain.
Mucinous content of
the SRC, microvacuolar type.
Cytokeratins: Absence of invasion of the muscularis mucosa or the
gastric carcinoma, intramucosal signet ring cell type.
IIb-c (Jap Gast Endosc Soc)
of the surrounding mucosa (Does SRC Ca In Situ Exist?)