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Iwamuro M, Fujii N, Tanaka T, Kanzaki H, Kawano S, Kawahara Y, Okada H. Squamous Metaplasia of the Stomach Associated with Lymphoma Infiltration. Intern Med 2021; 60:2229-2234. [PMID: 33612676 PMCID: PMC8355407 DOI: 10.2169/internalmedicine.6271-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We herein report a patient who presented with follicular lymphoma. Although the stomach was initially intact, mucosal redness and multiple erosions appeared in the gastric body owing to infiltration of the follicular lymphoma cells. Subsequently, a slightly depressed, white area lacking gastric mucosal structure was detected in the lesser curvature of the gastric cardia and body, where lymphoma cell infiltration was also pathologically observed beneath the stratified squamous epithelium. This case indicated that, although infrequent, prolonged mucosal injury owing to lymphoma infiltration can cause squamous metaplasia in the stomach.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Nobuharu Fujii
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | | | - Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal Endoscopy, Okayama University Hospital, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
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A first case of primary gastric verrucous carcinoma with isolated squamous epithelium in the stomach. Virchows Arch 2019; 475:115-119. [PMID: 30761414 DOI: 10.1007/s00428-019-02542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
Primary gastric squamous cell carcinoma (SCC) is a rare histological subtype of gastric cancer. Here, we report the first case of primary gastric verrucous carcinoma (VC), a well-differentiated variant of SCC. Gastroscopy revealed a papillary polypoid lesion at the posterior wall of the upper gastric body and isolated squamous epithelium at the greater curvature of the fornix in a 78-year-old woman. Endoscopic submucosal dissection was performed. Microscopically, the lesion comprised very well-differentiated squamous epithelium with minimal atypia and exhibited coarse papillary structure and bulbous epithelial downgrowth with submucosal invasion. Conventional SCC or adenocarcinoma components were not included, and the lesion was surrounded by the metaplastic intestinal mucosa. Human papillomavirus infection was not detected. Although the pathogenesis of primary gastric SCC remains controversial, here, the disease is suggested as having originated from squamous epithelium. Knowledge of primary gastric VC and difficulty in diagnosing it using surface biopsy is necessary.
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von Waagner W, Wang Z, Picon AI. A Rare Case of a Primary Squamous Cell Carcinoma of the Stomach Presenting as a Submucosal Mass. Case Rep Surg 2015; 2015:482342. [PMID: 26185704 PMCID: PMC4491394 DOI: 10.1155/2015/482342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/07/2015] [Indexed: 11/21/2022] Open
Abstract
We report a case of a 70-year-old man, with a status after aortic valve replacement, who presented with melena and hypotension. On physical examination, he was hypotensive, but he responded to resuscitation. Esophagogastroduodenoscopy revealed a submucosal mass in the gastric fundus. Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis. He underwent a partial diaphragmatic resection, gastrectomy, lymphadenectomy, and Roux-en-Y esophagojejunostomy. Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node. He received chemoradiation, but the patient expired 27 months after surgery.
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Affiliation(s)
- Wolf von Waagner
- Division of Surgical Oncology, Department of Surgery, Staten Island University Hospital, 256 B Mason Avenue, Staten Island, NY 10305, USA
| | - Zhuo Wang
- Department of Pathology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA
| | - Antonio I. Picon
- Division of Surgical Oncology, Department of Surgery, Staten Island University Hospital, 256 B Mason Avenue, Staten Island, NY 10305, USA
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Ahn S, Bae GE, Kim KM. Exuberant squamous metaplasia of the gastric mucosa in a patient with gastric adenocarcinoma. Diagn Pathol 2015; 10:46. [PMID: 25925374 PMCID: PMC4413529 DOI: 10.1186/s13000-015-0281-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 04/16/2015] [Indexed: 01/14/2023] Open
Abstract
Background The presence of squamous epithelium in the stomach is only occasionally encountered and is associated with prolonged mucosal injury. Squamous metaplasia in patients with cancer is relatively rare and only four cases have been reported in the stomach, all of which have been associated with squamous cell carcinomas. We present the first case of exuberant squamous metaplasia in a patient with gastric adenocarcinoma of the cardia. Case presentation A 56-year-old woman presented with epigastric pain and weight loss. Endoscopy showed an irregular depressed hyperemic lesion covered with a whitish plaque on the cardia. A total gastrectomy was performed and the tumor in the subcardia was found to extend up to the proximal stomach with diffuse squamous metaplasia in the surface of the tumor and proximal gastric mucosa in contiguity with the esophageal squamous epithelium. It is believed that the squamous extension from the esophagus to the proximal stomach and the gastric adenocarcinoma occurred at the same time. Conclusions Synchronous squamous metaplasia and underlying adenocarcinoma in the stomach is extremely rare. Recognition of this entity would be beneficial for clinicians to avoid unnecessary treatment. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1035146445160150.
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Affiliation(s)
- Sangjeong Ahn
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
| | - Go Eun Bae
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
| | - Kyoung-Mee Kim
- Department of Pathology & Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
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Sakemi R, So S, Morimitsu Y, Imada H, Ishihara H, Kuhara K, Oku Y, Terabe H, Kishi M, Sasaki E, Sakemi M, Shimokobe M. Endoscopic submucosal dissection of squamous cell carcinoma in the upper stomach 5 years after chemoradiotherapy for adenocarcinoma. Clin J Gastroenterol 2014; 7:310-5. [PMID: 26185878 DOI: 10.1007/s12328-014-0503-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/26/2014] [Indexed: 11/27/2022]
Abstract
Primary squamous cell carcinoma is rarely observed, with a reported incidence of 0.04-0.07 % of all gastric cancers. An 81-year-old male underwent chemoradiotherapy for type 1 gastric cancer of the posterior wall of the cardiac region in 2005. The tumor disappeared after 1 year of therapy, following which an area of white epithelium, approximately 30 mm in diameter and continuous with the esophageal mucosa, became visible. Biopsy of the white epithelium indicated normal squamous epithelium. An elevated lesion was subsequently detected in the area of white epithelium on upper gastrointestinal endoscopy during a follow-up examination 5 years after therapy. As a biopsy of the same site indicated squamous cell carcinoma, we performed endoscopic submucosal dissection. Histopathological examination indicated high-grade fibrosis due to radiotherapy and showed a moderately differentiated squamous cell carcinoma invading the scarred portion. We describe a case where the developmental process of a squamous cell carcinoma was observed using endoscopy, including narrow band imaging with magnification. This carcinoma likely originated from squamous metaplasia that developed after chemoradiotherapy was administered for a gastric cancer.
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Affiliation(s)
- Ryosuke Sakemi
- Department of Gastroenterology, Tobata Kyoritsu Hospital, Sawami 2-5-1 5F, Tobata-ku, Kitakyushu, Fukuoka, 804-0093, Japan,
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Jeon MS, Kim GH, Park DY, Jeong JH, Kahng DH, Jang HY, Choi JH, Park EK. A case of squamous metaplasia of the stomach. Clin Endosc 2013; 46:407-9. [PMID: 23964341 PMCID: PMC3746149 DOI: 10.5946/ce.2013.46.4.407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 09/17/2012] [Accepted: 09/24/2012] [Indexed: 11/29/2022] Open
Abstract
Intestinal metaplasia of the stomach is a common metaplastic lesion associated with chronic gastritis and mucosal atrophy. However, squamous metaplasia is a comparatively rare condition. On endoscopy, squamous metaplasia is usually observed as a whitish mucosal lesion in the lesser curvature of the cardiac region of the stomach. When Lugol's iodine solution is applied, the lesion stains brown in the same way as normal esophageal mucosa. We report a case of 79-year-old man with a whitish flat lesion in the lesser curvature of the cardiac region on surveillance endoscopy after endoscopic treatment of gastric adenoma. The endoscopic biopsy showed stratified squamous epithelial mucosa.
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Affiliation(s)
- Moo Song Jeon
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Cho YS, Kim JS, Kim HK, Ji JS, Kim BW, Chae HS, Han SW, Choi KY, Chung IS. A squamous metaplasia in a gastric ulcer scar of the antrum. World J Gastroenterol 2008; 14:1296-8. [PMID: 18300361 PMCID: PMC2690683 DOI: 10.3748/wjg.14.1296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
An 81-year-old man presented with epigastric pain and weight loss for one month. He had a past history of pulmonary tuberculosis, 10 years ago. We performed a gastroscopy, which showed a linear depressed whitish gastric ulcer scar (0.8 cm in length) in the posterior wall of the prepyloric antrum. The result of biopsy was reported as squamous epithelium. Immunohistochemical staining using an antibody to high molecular weight cytokeratin (HMC) revealed positive staining in the squamous epithelium. Two years later, the lesion was followed up. The lesion remained at same site endoscopically, but no squamous epithelium could be seen microscopically.
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Kline TJ, De las Morenas T, O'Brien M, Smith BF, Afdhal NH. Squamous metaplasia of extrahepatic biliary system in an AIDS patient with cryptosporidia and cholangitis. Dig Dis Sci 1993; 38:960-2. [PMID: 8482197 DOI: 10.1007/bf01295928] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AIDS-related cholangiopathy is an increasingly recognized syndrome associated with significant morbidity and mortality. The mechanism of cholangiopathy is unknown but is assumed to be related to infectious pathogens such as CMV and cryptosporidia. The case of a Haitian with HIV and long-standing intestinal cryptosporidiosis who presented with cholangitis and protuberant intrabiliary filling defects is reported. Histopathological examination of biliary biopsies revealed previously unreported extensive squamous metaplasia of the bile duct epithelium, and the histogenesis of this condition is discussed. Chronic cryptosporidial infestation may be directly pathogenic resulting in squamous metaplasia that mimics biliary malignancy.
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Affiliation(s)
- T J Kline
- Department of Medicine, Boston City Hospital, Massachusetts 02118
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Callery CD, Sanders MM, Pratt S, Turnbull AD. Squamous cell carcinoma of the stomach: a study of four patients with comments on histogenesis. J Surg Oncol 1985; 29:166-72. [PMID: 4079395 DOI: 10.1002/jso.2930290307] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The histogenic origin of squamous carcinoma of the stomach (SCS) is controversial. We report the case of a 55-year-old man who developed SCS following successful chemotherapy for generalized well-differentiated lymphocytic lymphoma. The patient's stomach contained both squamous carcinoma arising in squamous metaplasia and chronic atrophic gastritis with intestinal metaplasia. This case is compared to three additional cases of SCS where no such antecedent mucosal changes were evident. The SCS literature is reviewed and the histogenesis regarding the development of pure squamous tumors of the stomach is discussed.
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Mingazzini PL, Barsotti P, Malchiodi Albedi F. Adenosquamous carcinoma of the stomach: histological, histochemical and ultrastructural observations. Histopathology 1983; 7:433-43. [PMID: 6192071 DOI: 10.1111/j.1365-2559.1983.tb02256.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The histochemical and ultrastructural features of an adenosquamous carcinoma of the stomach have been studied. Both the adenomatous and the squamous component of the tumour showed malignant characteristics. Elements which were considered as undifferentiated cells on light microscopy showed ultrastructural features of poorly differentiated squamous cells. No intermediate cells, sharing squamous and glandular aspects, were found by electron microscopical examination. The adenomatous component exhibited histochemical and ultrastructural features of the intestinal type of gastric carcinoma and the mucosa surrounding the tumour showed a colonic type of intestinal metaplasia. A possible histogenesis from a totipotential undifferentiated cell is considered.
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Abstract
Abstract
Two cases of primary squamous-cell carcinoma arising in a stomach damaged by corrosive acid burns are reported. Thirty-three previously reported cases of pure squamous carcinoma of the stomach are tabulated and their pathogenesis is discussed. A plea is made for treating corrosive acid burns of the stomach by some form of resection of the entire area involved rather than by more conservative methods, such as gastrojejunostomy, which have been used in the past.
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De Muro P. Tumore Gastrico Sperimentale. TUMORI JOURNAL 1947; 33:148-56. [DOI: 10.1177/030089164703300305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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