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This is a case of papillary adenocarcinoma. Pathologic interpretation is tricky about whether it is an EGC or an AGC.
Advanced gastric carcinoma
1. Location : lower third, center at antrum and lesser curvature
2. Gross type : Borrmann type 3
3. Histologic type : papillary adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 4.3x3.2 cm
6. Depth of invasion : extension to proper muscle (pT2a)
7. Resection margin: free from carcinoma, safety margin: proximal, 7.5 cm; distal, 1.8 cm
8. Lymph node metastasis: metastasis to one out of 63 regional lymph nodes (pN1)
9. Lymphatic invasion : present
10.Venous invasion : present (intramural)
11.Perineural invasion : not identified
Note: This carcinoma can be classified as SM3-massive by Japanese classification.
The pathology note is very unusual. Japanese pathologists are different from pathologist in other countries.
이상한 note가 붙어있지요? 조기위암과 진행성위암의 구분에도 국가간 차이가 있습니다. 이 증례가 전형적인 예입니다. 2021년 6월 4일 병리과 안수민 선생님을 모시고 제2회 내시경 병리 세미나를 진행하면서 SM3 massive에 대하여 논의하였습니다.
© 2014-11-16. 이준행
