2018년 8월 5일 일요일

Borrmann type 2 or 3

Borrmann type 2 is not clearly defined. If ulcerative mass lesion is big, some invasion is usually seen. In such case, endoscopist usually call it Borrmann type 2, but the pathologist usually call it Borrmann type 2.

 
Stomach, subtotal gastrectomy: Advanced gastric carcinoma 
1. Location : lower third, Center at antrum and anterior wall 
2. Gross type : Borrmann type 3 
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated 
4. Histologic type by Lauren : diffuse 
5. Size : 8x7 cm 
6. Depth of invasion : penetrates subserosal connective tissue (pT3) 
7. Resection margin: free from carcinoma 
8. Lymph node metastasis : no metastasis in 53 regional lymph nodes (pN0) 
9. Lymphatic invasion : not identified 
10. Venous invasion : not identified 
11. Perineural invasion : present 
12. Associated findings : chronic active peritonitis with fibrous adhesion between liver tissue and gastric omentum 
13. Peritoneal cytology : negative 
14. AJCC stage by 7th edition: T3 N0

이 정도 내시경 사진이면 내시경 의사도 보만 3형으로 부르는 것이 더 좋을 것 같습니다.

한 가지 더. 이 환자에서는 종양과 liver 사이에 invasion은 뚜렷하지 않으나 fibrous adhesion이 보였다는 점이 특이했습니다.


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