Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by HongXiu Ji, M.D. and prepared by Marc Halushka M.D., Ph.D.
Case 4: 81-year-old woman with weight loss and anorexia.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 156: Case 4
81-year-old woman with weight loss and anorexia.images/halushka/conf92203/case4image1.jpg
images/halushka/conf92203/case4image11.jpg
images/halushka/conf92203/case4image2.jpg
images/halushka/conf92203/case4image3.jpgCorrect
Answer: Medullary carcinoma of the stomach
Histology: The sections show a poorly differentiated tumor with pushing borders. The tumor cells are poorly differentiated, polygonal with marked cytologic atypia and mitosis, and scattered throughout a prominent lymphoid stroma. The tumor extends into the full thickness of the muscularis propria, but does not extend out into the perigastric soft tissue. All sampled regional lymph nodes are negative for carcinoma.
Discussion: This is an uncommon variant of adenocarcinoma of the stomach. Medullary carcinoma, also called lymphoepithelioma-like carcinoma, has distinct gross and histological appearance and growth pattern. They usually arise in the distal portion of the stomach with grossly bulky tumor. However, the tumor tends to have a pushing border rather than being infiltrative. There is a dense lymphoid infiltrate composed of both B and T lymphocytes. It has been shown that medullary carcinoma cells contain Epstein-Barr virus (EBV) genetic sequences. Despite its ugly cytology, medullary carcinoma of the stomach has a better prognosis than ordinary gastric carcinoma on a stage for stage basis.
Incorrect
Answer: Medullary carcinoma of the stomach
Histology: The sections show a poorly differentiated tumor with pushing borders. The tumor cells are poorly differentiated, polygonal with marked cytologic atypia and mitosis, and scattered throughout a prominent lymphoid stroma. The tumor extends into the full thickness of the muscularis propria, but does not extend out into the perigastric soft tissue. All sampled regional lymph nodes are negative for carcinoma.
Discussion: This is an uncommon variant of adenocarcinoma of the stomach. Medullary carcinoma, also called lymphoepithelioma-like carcinoma, has distinct gross and histological appearance and growth pattern. They usually arise in the distal portion of the stomach with grossly bulky tumor. However, the tumor tends to have a pushing border rather than being infiltrative. There is a dense lymphoid infiltrate composed of both B and T lymphocytes. It has been shown that medullary carcinoma cells contain Epstein-Barr virus (EBV) genetic sequences. Despite its ugly cytology, medullary carcinoma of the stomach has a better prognosis than ordinary gastric carcinoma on a stage for stage basis.
