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위의 초고분화 선암의 진단적병리소견의 연구

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Abstract
Background
Extremely we differentiated adenocarcinoma (EWDA) is a deceptively bland-looking adenocarcinoma of the stomach. It often causes diagnostic problems, especially in endoscopic biopsy samples. To better recognize this tricky malignancy, we carefully reviewed a series of EWDAs treated at our institution.
Design
A total of 55 specimens from 19 patients were obtained. Gross and microscopic features defining EWDA were described and documented. For comparison, normal surrounding epithelium, regenerative atypia, hyperplastic polyp, and foveolar epithelial hyperplasia specimens were randomly selected and reviewed.
Results
Most cases (18 of 19, 94.7%) were advanced gastric cancer (AGC) and primarily located in the body of the stomach (15 of 19, 79.0%). The majority of AGCs were non-ulcerated (11 of 18, 61.1%) with an undermining pattern of invasion and relatively small mucosal involvement. Specific histologic features included an irregular glandular shape, an undulating apical cytoplasmic border, disproportionately large glands, irregularly spaced nuclei and a variably distended mucinous cytoplasm. Classical features, such as small infiltrating glands or desmoplastic reactions, were barely observed. Identification of disproportionately large glands against the surrounding normal glands, indicating glandular cancerization, as well as the atypical cytologic features described above was helpful for making a diagnosis from a biopsy sample. Such subtle signs of malignancy were missed in some of the preprocedural forceps biopsies (7 of 19, 37.0%).
Conclusion
Awareness of its histomorphologic characteristics that were described in this report would lead to a more timely diagnosis and would prevent repeated endoscopic procedures.
Author(s)
이종원
Issued Date
2021
Awarded Date
2021-08
Type
Dissertation
Keyword
Stomach neoplasmsAdenocarcinomaMissed Diagnosis
URI
https://oak.ulsan.ac.kr/handle/2021.oak/5865
http://ulsan.dcollection.net/common/orgView/200000508248
Alternative Author(s)
Jongwon Lee
Affiliation
울산대학교
Department
일반대학원 의학과
Advisor
김지훈
Degree
Master
Publisher
울산대학교 일반대학원 의학과
Language
eng
Rights
울산대학교 논문은 저작권에 의해 보호받습니다.
Appears in Collections:
Medicine > 1. Theses (Master)
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