Medullary Carcinoma with Lymphocytic Infiltration of the Stomach with Attention to Characteristic Gross Appearance Toshinari Minamoto 1 , Masayoshi Mai 1 , Takahito Ohta 1 , Kazuhiko Omote 1 , Kishichiro Watanabe 2 1Department of Surgery, Cancer Research Institute, Kanazawa University 2Department of Pathology, National Kanazawa Hospital Keyword: 胃癌 , リンパ球浸潤性髄様癌 , 肉眼型 pp.799-806
Published Date 1995/5/25
DOI https://doi.org/10.11477/mf.1403105431
  • Abstract
  • Look Inside
  • Cited by

 Medullary carcinoma with lymphocytic infiltration (MCLI) of the stomach is a unique neoplastic entity, characterized histologically by the sparse population of small nests of poorly differentiated carcinoma cells and intense and diffuse lymphocyte infiltration, and clinically by an excellent prognosis. Such histopathological and clinical implications encouraged us to investigate 30 patients with gastric MCLI, including seven with early MCLI and 23 with advanced MCLI, paying particular attention to gross findings. Representatively, gastric MCLI grossly showed a sharply demarcated, raised border and an ulcerated center, corresponding to Ⅱa+Ⅱc type and Borrmann 2 type in early and advanced carcinomas, respectively. The other striking gross characteristic was that, in two cases of early MCLI and 10 cases of advanced MCLI, gross findings of the tumor could not be included under any of the classifications of the Japanese Research Society for Gastric Cancer. These 12 tumors showed variable curious configurations, that is, two early MCLI and seven advanced MCLI appeared to be malignant lymphoma, and the other three advanced MCLI resembled submucosal tumor. The gross appearance of gastric MCLI did not correlate with the site, histopathologic factors, lymphocyte subpopulations, lymph node metastasis, or prognosis. Postoperative surveillance revealed that only four patients with the tumor showing serosal invasion and extensive nodal involvement had died of recurrence. Although gastric MCLI is a histopathologic entity, the unique gross appearances and favorable postoperative survival suggest that preoperative diagnosis is important for clinical management of the patients. Endoscopic ultrasound and jumbo biopsy could be useful for clinical evaluation of this tumor.

Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院