2018년 7월 28일 토요일

Evaluation of depth of invasion is always difficult

Endoscopic evaluation of invasion depth is tricky. In this lesion, the forceps biopsy was signet ring cell carcinoma. The depth of invasion was...

 
Stomach, subtotal gastrectomy: Advanced gastric carcinoma 
1. Location : middle third, Center at body and greater curvature 
2. Gross type : Borrmann type 2 
3. Histologic type : signet-ring cell carcinoma 
4. Histologic type by Lauren : diffuse 
5. Size : 3.6x2.7 cm 
6. Depth of invasion : invades muscularis propria (pT2) 
7. Resection margin: free from carcinoma 
8. Lymph node metastasis : no metastasis in 44 regional lymph nodes (pN0) 
9. Lymphatic invasion : not identified 
10. Venous invasion : not identified 
11. Perineural invasion : present 
12. Peritoneal cytology : negative 
13. AJCC stage by 7th edition: pT2 N0

종양 부분의 위벽이 두꺼워져 궤양부 바닥이 주변 점막보다 높아진 점, multiple fusion folds, tumor islands, signet ring carcinoma 등의 depth of invasion이 제법 깊을 수 있다는 점을 시사하는 증례입니다.


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