39 year old Gastric biopsy Loss of appetite and anaemia Gastric ulcer 2.5cm in body HPE findings limited to mucosa



Possibilities 1. Poorly differentiated carcinoma 2. Malignant GIST imparting focal signet ring morphology

Hi Dr Mohit the lesion was focal and only mucosal No infiltration of muscularis mucosae was seen

Section shows gastric mucosa with ulceration and fragments of a malignant neoplasm arranged in sheets composed of cells with hyperchromatic nuclei exhibiting pleomorphism. Signet ring cells are also seen. Scant necrosis is present in background with some desmoplastic response. Histopathological features are suggestive of a poorly differentiates adenocarcinoma with signet ring cell features.

Sections show a tiny bit of gastric mucosa with ulceration and mostly tumor. Tumor shows diffusely arranged cells in sheets seperated by fibrous tissue (desmoplasia). Cells have round to oval pleomorphic hyperchromatic nuclei with moderate cytoplasm and few signet ring forms seen. S/O: diffuse type (signet ring)of gastric adenocarcinoma

Sections from gastric mucosa are suggestive of diffuse signet ring cell adenocarcinoma stomach.

Poorly differentiated Adenocarcinoma-Intramucosal. Advised IHC with CK7.

Intramucosal Diffuse signet ring adenocarcinoma DD from pseudosignet ring cells with inflammation , however pseudosignet ring cells are organised clusters, can show mitosis and hyperchromatism.

Respected sir how to differentiate between intramucosal diffuse adenocarcinoma pseudosignet ring cell type from signet ring cell type adenocarcinoma

FSO : *Poorly Differentiated Carcinoma.Advised PAS-D stain & IHC.

Sir is it a high grade lymphoma

diffuse gastric carcinoma with anaplastic signet ring cells.

Poorly differentiated adenocarcinoma

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