We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the sto...We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach.Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis.Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase.Laparoscopic wedge resection was performed for definitive diagnosis.Pathologically,the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis.Serum gastrin levels were normal.As a radical treatment,laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery.Finally,pathological examination revealed no lymph node metastasis.展开更多
A gastric biopsy specimen from a 14-year-old Yorkshire terrier was analysed using light microscopy, immunohistochemistry and transmission electron microscopy. The biopsies were obtained from a 3 × 3 × 4 cm m...A gastric biopsy specimen from a 14-year-old Yorkshire terrier was analysed using light microscopy, immunohistochemistry and transmission electron microscopy. The biopsies were obtained from a 3 × 3 × 4 cm mass located at the gastric cardia. Light microscopy revealed solid nests and sheets of tumour cells separated by abundant fibrovascular stroma in all gastric layers. The tumour cells were monomorphic, with eosinophilic cytoplasm and demonstrated palisading at the periphery. Nuclei were round to oval with densely packed chromatin and inconspicuous nucleoli. The tumour cells immunohistochemically stained strongly positive for chromogranin A, synaptophysin, and pan-cytokeratin. Electron microscopy revealed electron dense neurosecretory granules of 100 - 150 nm in diameter. Metastases were found in regional lymph nodes. Gastric neuroendocrine carcinoma was diagnosed, according to the histological, immunohistochemical and electron microscopic features.展开更多
The standard treatment in Japan for gastric carcinoid has been gastrectomy with lymphadenectomy. This report describes the possibility of endoscopic treatment as an appropriate option for gastric carcinoid fulfilling ...The standard treatment in Japan for gastric carcinoid has been gastrectomy with lymphadenectomy. This report describes the possibility of endoscopic treatment as an appropriate option for gastric carcinoid fulfilling certain conditions. A 46 year old woman underwent endoscopic mucosal resection for two 3 mm gastric carcinoids. The patient had hypergastrinemia with pernicious anemia and type A chronic atrophic gastritis, suggesting that the tumors were type Ⅰ in Rindi's classification. Both tumors were located in the mucosal layer with no cellular polymorphism and were chromogranin A positive. Neither tumor recurrence in the stomach nor distant metastases have been documented during the 5 years of follow-up. Although many type Ⅰ gastric carcinoids may be clinically indolent, reports on successful endoscopic treatment for this carcinoid have been scanty in the literature in Japan, presumably because of the hitherto surgical treatment stance for the disease. This report discusses how the size, number, depth and histological grading of the type Ⅰ gastric carcinoid could allow the correct identification of a benign or malignant propensity of anindividual tumor and how endoscopic resection could be a treatment of choice when these factors render it feasible. This stance could also obviate unnecessary surgical resection for more benign tumors.展开更多
文摘We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach.Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis.Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase.Laparoscopic wedge resection was performed for definitive diagnosis.Pathologically,the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis.Serum gastrin levels were normal.As a radical treatment,laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery.Finally,pathological examination revealed no lymph node metastasis.
文摘A gastric biopsy specimen from a 14-year-old Yorkshire terrier was analysed using light microscopy, immunohistochemistry and transmission electron microscopy. The biopsies were obtained from a 3 × 3 × 4 cm mass located at the gastric cardia. Light microscopy revealed solid nests and sheets of tumour cells separated by abundant fibrovascular stroma in all gastric layers. The tumour cells were monomorphic, with eosinophilic cytoplasm and demonstrated palisading at the periphery. Nuclei were round to oval with densely packed chromatin and inconspicuous nucleoli. The tumour cells immunohistochemically stained strongly positive for chromogranin A, synaptophysin, and pan-cytokeratin. Electron microscopy revealed electron dense neurosecretory granules of 100 - 150 nm in diameter. Metastases were found in regional lymph nodes. Gastric neuroendocrine carcinoma was diagnosed, according to the histological, immunohistochemical and electron microscopic features.
文摘The standard treatment in Japan for gastric carcinoid has been gastrectomy with lymphadenectomy. This report describes the possibility of endoscopic treatment as an appropriate option for gastric carcinoid fulfilling certain conditions. A 46 year old woman underwent endoscopic mucosal resection for two 3 mm gastric carcinoids. The patient had hypergastrinemia with pernicious anemia and type A chronic atrophic gastritis, suggesting that the tumors were type Ⅰ in Rindi's classification. Both tumors were located in the mucosal layer with no cellular polymorphism and were chromogranin A positive. Neither tumor recurrence in the stomach nor distant metastases have been documented during the 5 years of follow-up. Although many type Ⅰ gastric carcinoids may be clinically indolent, reports on successful endoscopic treatment for this carcinoid have been scanty in the literature in Japan, presumably because of the hitherto surgical treatment stance for the disease. This report discusses how the size, number, depth and histological grading of the type Ⅰ gastric carcinoid could allow the correct identification of a benign or malignant propensity of anindividual tumor and how endoscopic resection could be a treatment of choice when these factors render it feasible. This stance could also obviate unnecessary surgical resection for more benign tumors.
