A Case of Stomach Tumor that Changed Histopathological Appearance After Chemotherapy

Global Journal of Pathology & Laboratory Medicine
Volume 1, Issue 5, July, Pages: 1-4

Received: May 29, 2022, Reviewed: May 30, 2022, Accepted: April 15, 2022, Published: July 11, 2022

Unified Citation Journals, Pathology 2022, 1(5) 1-04;
ISSN 2754-0952

Author: Prof. Alptekin Şen Lecturer, Istanbul Demiroglu Bilim University Faculty of Medicine, Department of Pathology, Istanbul, Turkey

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ABSTRACT: Previously, cancers; Although it is believed to be formed by the differentiation of tumors from mature cells, it is now believed to originate from stem cells. Relating to growth regulation of stem cells. Knowing is essential in cancer prophylaxis and treatment with neuroendocrine tumors.
Neuroendocrine Tumor; its association in the gastrointestinal tract can often be detected. However, in our case report, there is a case of gastric tumor differentiated after chemotherapy.

KEYWORDS: Adenocarcinoma, Neuroendocrine Carcinoma, Chemotherapy, Composite Tumor

INTRODUCTION: Gastric cancer; is the fourth most common cancer in men and the fifth most common in women. (1) The vast majority of stomach cancers; are Adenocarcinomas. Neuroendocrine carcinomas are observed less frequently in the stomach compared to other species. (2) In Our case; A diagnosis of ‘signet ring cell carcinoma’ was diagnosed in another center with endoscopic biopsy before, and the resection material examined after chemotherapy was given the diagnosis of ‘mixed neuroendocrine carcinoma containing cells with a signet ring cell appearance in places’ by us.

Our case is a 46-year-old female. Surrounding the lumen in a lunar style in November 2021, anterior stomach cardia Bloating, epigastric burning, gas, and swallowing 4-5 cm on the face. The direction was followed to the centre, where she applied with complaints of dyspnea, and a stomach cardia tumor was diagnosed.
In endoscopy, Biopsies were taken with the diagnosis of half in the lower end of the oesophagus examined in a private pathology laboratory. Biopsy samples; ‘signet ring cell a diagnosis of ‘weak cohesive carcinoma’ was given (pictures 1 and 2).

resim 1                                   resim 2 H&E x40 1

resim 1 & resim 2: H&E x40 1

On diagnosing, the patient Etopside 120mg and Cisplatin 30mg started to be implemented. February after multiple cycles of chemotherapy, partial gastrectomy, splenectomy in 2022, partial omentectomy, and celiac lymphatic chain-containing lymphadenectomy multi-operation operation material by applying the delivered to our laboratory.
The operation examined in our laboratory in their materials; gastric resection mater- just 5 cm from the esophagocardial border 3×2.5×2 cm at the lesser curvature. In size ulcerovegetative, hemorrhagic, solid, tumoral lesion watched. In other fields, gastric mucosa general was in normal appearance. Fourteen from the greater curvature region, lesser curvature spleen and spleen hilus and omentum canal-having a total of 32 ma and congestion areas, 18 of which are from the region the lymph node was removed. The celiac lymph nodes were macroscopically normal, except the registered nine lymph nodes were extracted from the sample. Resection material in microscopy prepared from the defined lesioned area in sections; will form slots and cords well organised, some narrow, some medium fine granular, with a degree of cytoplasm containing nuclei with chromatin structure Tumors composed of atypical epithelial cells existence of the structure was observed. (pic 3 4). In the examination of lymph nodes, only small in 3 lymph nodes were extracted from the curvature in which metastasis was detected. Spleen, omentum, and others in the stomach areas; edema, congestion and reactive changes.

resim 3 H&E x10 1                           resim 4 H&E x40 1

resim 3 : H&E x10 1 and resim 4: H&E x40 1

At this stage, the case was previously given, learning that the diagnosis mentioned above has been equivalent to both biopsy samples on separate dates on time; Chromogranin, Synaptophysin, and MUC-2 immunohistochemical specific stains do. After all, first-diagnosis endoscopic biopsy MUC-2 immunohistochemistry in the sample Staining followed by Chromogranin staining and no staining with Synaptophysin was observed. (picture 5-6)

resim 5 MUC-2 x40 1                              resim 6 Cromogranin X40 1

resim 5 : MUC-2 x40 1 and resim 6: Cromogranin X40  1

Evaluated by us and ultimately ‘Mikst evaluated as ‘type neuroendocrine carcinoma’ In the resurrected case, an endoscopic biopsy of the case Contrary to MUC-2, no staining was observed, Staining with Synaptophysin and Chromogranin has been followed. (picture 7-8)

resim 7 Synaptofizin X40 1                          resim 8 MUC-2 X40 1

resim 7: Synaptofizin X40 1 and resim 8: MUC-2 X40 1

In our case, most cancers originate from stem cell studies that support the hypothesis and contribute. This situation; also affect the progno- and causes the disease to progress less aggressively. (4). Recently, Fujiyoshi et al.endocrine and non-endocrine tumor associations. According to the classification that includes six categories, our case simultaneous neuroendocrine and non-neuroendocrine differential can be evaluated in the category of ‘infecting tumors’. knows. (5) In addition, collisional neoplasms appear adjacent to each other and of the same cell type, and exocrine and neuroendocrine tumors that are not caused by may also appear. (6)


1. .Jemal A, Bray F, Center MM, Ferlay J, Ward E, Diagnostic differences; tumor cell growth regulation Forman D, Global cancer statistics.CA Cancer J revealing important contributions to prophylaxis and treatment Clin 2011; 61 (2): 69-90 can provide. ( 3 )
2. Hamilton SR,Aaltonen LA,eds.Tumors of the Digestive System.In: World Health Organization Classification of Tumors: Pathology and Genetics, JARC Press, Lyon, France 2000
3. Helge Waldum, Patricia G.Mjones.Int J.Mol.Sci. August 2020 11;21 (16) : 5751
4. Summer L.Nugent, Steven C.Cunningham, Borislav A.Alexiev, Emily Bellevance, Jhon C.Papadimitrou Nader Hanna. Diagnostic Pathology November 2007 2:43 2005:823-829
5. Fujiyoshi Y, Kuhara H, Elmoto T, PicturePract, Composite glandular -endocrine cell carcinoma of the stomach.Res.Pract .2005 :823-829
6. Capella C, La Rossa S, Ucella S, Billo P Cornaggia M. Mixed endocrine -exocrine tumors of the gastrointestinal tract. Diagn.Pathol 2000:17: 91-103

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To citation of this article: Dr. Alptekin Şen, Istanbul Demiroglu Bilim University Faculty of Medicine, Department of Pathology, Istanbul/Turkey

Correlation of A Case Of Stomach Tumor Changıng Hıstopathologıcal Appearance After Chemotherapy, Global Journal of Pathology & Laboratory Medicine

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