Sümeyye EKMEKCI, Yelda DERE, Mustafa DEĞİRMENCİ, Bülent ÇALIK, Özgül SAĞOL, Sulen SARIOGLU

GASTRIC CARCINOMA WITH LYMPHOID STROMA (GASTRIC MEDULLARY CARCINOMA): RARE CASE REPORT

Mide medüller karsinomu olarak da bilinen lenfoid stroma ilişkili mide karsinomu (GCLS), lenfositlerden zengin bir stroma içerisinde kötü düzenlenmiş tübül yapıları ile karakterize midenin nadir görülen bir neoplazisidir. Çoğu GCLS Epstein- Barr virüs (EBV) ile ilişkilidir. Burada 76 yaşında erkek GCLS olgusu sunulmaktadır. Gastroskopik muayenede kardiyada ülsere kitle saptanan olgu, endoskopik biyopsisinden kötü diferansiye adenokarsinom tanısı aldı. Gastrektomi sonrası mikroskobik incelemede subserozal alanda sınırlanmış, lenfositten zengin stromada, solid paternde gelişim göstermiş büyük ve pleomorfik, veziküler nükleuslu hücrelerden oluşan, itici sınırlara sahip tümör izlendi. In-situ hibridizasyonda EBV encoded RNA (EBER) lenfoid hücrelerde pozitifti. Hastalık evre T3N0M0’dı. Hasta sistemik adjuvan tedavi almıştır. 36 aylık takibinde, şu ana kadar nüks saptanmamıştır.

Anahtar Kelimeler:

EBV İlişki Kanserler, Gastrik Kanserler, Gastrik Medüller Karsinom

Gastric Carcinoma With Lymphoid Stroma (Gastric Medullary Carcinoma): A Rare Case Report

Gastric carcinoma associated with lymphoid stroma (GCLS), also known as gastric medullary carcinoma is a rare neoplasia of the stomach which is characterized with poorly developed tubular structures admixed within a lymphocyte-rich stroma. Most of the GCLS are found to be associated with Epstein-Barr virus (EBV) infection. Herein we present a case of GCLS in a 76-year-old patient. Gastroscopic examination revealed an ulcerated mass located at the cardia and the biopsy was diagnosed as poorly differentiated adenocarcinoma. After gastrectomy, the microscopic examination revealed an ulcerated tumor limited to the subserosa with pushing borders and dense lymphocytic infiltrate. The tumor diffusely consisted of sheets of pleomorphic tumor cells showing vesicular nuclei. In-situ hybridization analysis of EBV encoded RNA (EBER) was positive lymphoid cells. The disease was staged as T3N0M0. He had no relapse until now and he is under follow-up for 36 months treated with adjuvant systemic treatment.

Keywords:

EBV Related Cancers, Gastric Cancers, Gastric Medullary Carcinoma,

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