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[EBV-associated gastric cancer]

1. Introduction

2. EBV-associated gastric cancerÀÇ ÀÓ»óÀû Ư¼º

3. Cases

4. References


1. Introduction

EBV-associated gastric cancer


2. SMC Monday GI conference 2017-5-15. EBV-associated gastric cancerÀÇ ÀÓ»óÀû Ư¼º (ÀÓ»ó°­»ç È«ÁöÅÃ)

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Latent protein ¹ßÇö ¾ç»ó¿¡ µû¶ó ¼¼ °¡Áö typeÀ» ³ª´­ ¼ö ÀÖ½À´Ï´Ù. À§¾ÏÀº latency type I°ú type II°ú °ü·ÃµÈ °ÍÀ¸·Î »ý°¢µË´Ï´Ù. óÀ½¿¡´Â latency type III·Î ½ÃÀÛÇÏ´Ù°¡ latent protein ¹ßÇöÀ» down regulation ÇÏ¿© latency type II¿Í type IÀ¸·Î º¯ÇüµË´Ï´Ù.

Remnant gastric cancer¿¡¼­ÀÇ °¨¿°À²ÀÌ ±×³É proximal gastric cancerº¸´Ù ÈξÀ ´õ ¸¹½À´Ï´Ù. Billroth II¿¡¼­ ´õ ³ô´Ù°í ÇÕ´Ï´Ù.


[Cases]

EBV-associated gastric cancer is usually diagnosed by careful pathologic examination and immunohistochemistry after gastrectomy. In this case, however, association with EBV was found by forceps biopsy specimen.

Cancer 889

Stomach, radical total gastrectomy: Early gastric carcinoma
1. Location : upper third, Center at cardia (Siewert II) and lesser curvature
2. Gross type : EGC type IIa
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated
4. Histologic type by Lauren : indeterminate
5. Size : 4.5x2.8 cm
6. Depth of invasion : invades submucosa (sm3) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 0.2 cm, distal 20.2 cm
8. Lymph node metastasis : metastasis to 1 out of 25 regional lymph nodes (pN1) (perinodal extension: absent) (1/25: "1", 1/1; "2", 0/0; "3", 0/7; "4", 0/5; "5", 0/0; "6", 0/1; "7", 0/2; "9", 0/6; "8a", 0/1; "11p", 0/0; "12a", 0/1; "4sb", 0/0; "11", 0/1)
9. Lymphatic invasion : present
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Associated findings : gastritis cystica profunda
13. Peritoneal cytology : negative
14. AJCC stage by 8th edition: pT1b N1
. c-erbB-2(HER2) : Negative ( 1+ )
. Epstein-Barr virus in-situ hybridization: Positive (Inflamed / TSP - High)



Early gastric carcinoma
1. Location : body, postero greater curvature
2. Gross type : EGC type IIb
3. Histologic type : tubular adenocarcinoma, moderately differentiated (EBV-positive)
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 34 mm (2) vertical diameter, 29 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 600 §­) (pT1b)
7. Resection margin : free from carcinoma(N), safety margin : distal 3 mm, proximal 200 §­, anterior 4 mm, posterior 2 mm, deep 100 §­ (sm only)
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: absent
13. in situ hybridization: Epstein-Barr virus : Positive ( CLR, Crohn's-like reaction )


[References]

1. EndoTODAY Lymphoepithelioma-like carcinoma



© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.