Stomach برای بزرگنمایی عکسها کلیک را روی ان نگه دارید Figure 14.1 Heterotopic pancreatic tissue presenting radiographically as a small, round nodule with central umbilication in the antrum Figure 14.2 Island of exocrine pancreatic tissue composed of acini within the gastric mucosa Figure 14.3 Low-Power View of a Gastric Biopsy With Helicobacter pylori-Related Gastritis. A, The lamina propria is expanded by lym- phocytes and plasma cells. B, High-power view showing prominent plasmacytosis of the lamina propria and neutrophil-mediated epithelial injury (activity). C, Immunohistochemical stain for H. pylori revealing rare organisms within the mucous layer Figure 14.4 Gastric body with atrophic gastritis including intestinal metaplasia Figure 14.5 Immunohistochemical stain for chromogranin showing linear staining indicative of a neuroendocrine proliferation in the setting of atrophic gastritis Figure 14.6 Reactive gastropathy with loss of mucin within the epithelium and regenerative nuclear changes Figure 14.7 Gross appearance of hemorrhagic gastritis as seen at autopsy. The entire gastric mucosa is involved by fresh hemorrhage Figure 14.8 Collagenous gastritis with thickening of the subepithelial collagen table Figure 14.9 Lymphocytic gastritis showing significant surface epithelial lymphocytosis Figure 14.10 Multiple acute ulcers of the stomach occurring in a chroni- cally debilitated patient. Microscopically, there was little fibrous reaction in the ulcer bed Figure 14.11 A, Typical gross appearance of chronic peptic ulcer of the stomach. Sharply delimited chronic peptic ulcer with converging folds of mucosa in the upper half. B, The ulcer bed is covered by fibrinopurulent exudate Figure 14.12 Whole-Mount View of Chronic Peptic Ulcer. The external muscle layer has been totally destroyed. Note the overhanging mucosa on one edge and the sloping mucosa on the other Figure 14.13 Whole-mount view of gastritis cystica profunda Figure 14.14 Huge Trichobezoar Removed From the Stomach. The tangled mass of hair looks like a mold of the gastric cavity Figure 14.15 A, Gross appearance of gastric polyps of hyperplastic type. Many of the lesions show central umbilication. Low-power micro- scopic view of gastric polyps of hyperplastic type. B, The cystic dilation of the glands is more evident on the left side Figure 14.16 Gross appearance of gastric adenomatous polyps. The larger lesion is a tangle of finger-like projections Figure 14.17 A, Adenomatous polyp. B, Villous adenoma. (From Oota K, Sobin LH. Histological Typing of Gastric and Oesophageal Tumours. Geneva: World Health Organization; 1977.) Figure 14.18 Large gastric villous adenoma containing areas of adeno- carcinoma. The tumor was located near the cardia Figure 14.19 Low-power (A) and higher-power (B) views of a gastric pyloric gland adenoma Figure 14.20 Low-power (A) and high-power (B) views of a fundic gland polyp with cystic dilation of fundic glands Figure 14.21 Fundic gland polyp with a focus of high-grade dysplasia Figure 14.22 Gross appearance of inflammatory fibroid polyp of stomach. The surface has a knobby appearance Figure 14.23 Low-grade (A) and higher-power (B) views of a gastric inflammatory fibroid polyp. Concentric cellularity and fibrosis around blood vessels is a prominent feature, as is a scattering of eosinophils Figure 14.24 Gross Appearance of Ménétrier Disease. The entire fundic mucosa is involved by an exuberant proliferative change. Note the sharp edge of the lesion at the junction of the fundus and antrum Figure 14.25 Microscopic Appearance of Ménétrier Disease. There is marked hyperplasia of the foveolar epithelium accompanied by atrophy of the underlying secretory mucosa Figure 14.26 Low-power (A) and high-power (B) views of gastric mucosa in a patient with Zollinger-Ellison syndrome. Note the large increase in the number of parietal cells Figure 14.27 High-grade dysplasia of the gastric mucosa showing prominent villiform architecture Figure 14.28 Gross appearance of polypoid gastric adenocarcinoma Figure 14.29 Gross appearance of gastric adenocarcinoma of ulcerative type showing marked resemblance to chronic peptic ulcer Figure 14.30 Gastric adenocarcinoma of intestinal type Figure 14.31 Typical gross appearance of diffuse carcinoma of the stomach (so-called linitis plastica). Virtually the entire gastric wall is involved by tumor. Note the prominence of rugal folds Figure 14.32 Gastric adenocarcinoma of diffuse type showing a single-file pattern of infiltration of the muscularis propria Figure 14.33 Intracytoplasmic mucin droplet in the cell in the very center is seen on this Mayer mucicarmine stain Figure 14.34 Gross appearance of mucinous adenocarcinoma of the stomach. The cut surface has a homogeneous gelatinous appearance Figure 14.35 Microscopic appearance of mucinous adenocarcinoma of the stomach. In contrast to diffuse carcinoma, most of the mucin is located extracellularly Figure 14.36 Cytologic appearance of reactive (reparative) atypia Figure 14.37 Cytologic appearance of intestinal-type gastric adenocarcinoma Figure 14.38 Cytologic appearance of diffuse-type gastric adenocarcinoma Figure 14.39 Early gastric adenocarcinoma limited to the mucosa Figure 14.40 A, Well-differentiated neuroendocrine tumor of the stomach composed of enterochromaffin-like cells. B, Immunohistochemical stain for chromogranin Figure 14.41 Low-power (A) and high-power (B) views of a low-risk gastrointestinal stromal tumor of the stomach of spindled type. Note the prominent perinuclear vacuoles. The cells are cytologically bland, and mitotic activity is not seen Figure 14.42 High-Risk Spindled Type of Gastrointestinal Stromal Tumor of the Stomach. A, The cells are tightly packed and arranged in sweeping fascicles. Perinuclear vacuoles are not apparent. B, Mucosal invasion is often associated with aggressive behavior in these tumors Figure 14.43 Epithelioid type of gastrointestinal stromal tumor of the stomach, low-risk type. The cells have abundant cytoplasm and a somewhat plasmacytoid appearance Figure 14.44 Highly cellular high-risk epithelioid gastrointestinal stromal tumor of the stomach Figure 14.45 Diffuse CD117 (KIT) immunoreactivity in a high-risk epithelioid gastrointestinal stromal tumor of the stomach. Perinuclear globular immunoreactivity can also be seen Figure 14.46 Gross appearance of a liver metastasis from a gastric GIST Figure 14.47 MALT-type lymphoma of the stomach involving mucosa and submucosa Figure 14.48 High-power view of mucosal involvement by MALT-type lymphoma. A few of the neoplastic lymphocytes are seen within the glandular epithelium (lymphoepithelial lesion) Figure 14.49 A, Large cell lymphoma of the stomach presenting as a large ulcerated mass. B, Large cell lymphoma of the stomach presenting grossly as a large polypoid mass with central ulceration Figure 14.50 High-power view of a large cell lymphoma of the stomach with transmural involvement. The pleomorphism and the presence of multinucleated giant cells may cause confusion with Hodgkin lymphoma Figure 14.51 A and B, Two cases of glomus tumor of the stomach. The small size of the round epithelioid cells and the intimate relationship with blood vessels with dilated lumina are characteristic Figure 14.52 Granular cell tumor of the stomach with nests of granular cells Figure 14.53 A, Characteristic low-power view of a gastric schwannoma with a prominent peripheral lymphoid infiltrate. B, High-power view showing a trabecular pattern in this gastric schwannoma Figure 14.54 A, Mixed adenocarcinoma and choriocarcinoma of the stomach, adenocarcinomatous portion. B, Choriocarcinomatous portion surrounded by massive hemorrhage Figure 14.55 Yolk sac tumor of the stomach associated with a high elevation of serum AFP levels Figure 14.56 Lobular Carcinoma of the Breast Metastatic to Stomach. The tumor cells grow in a diffuse fashion within the lamina propria mimicking the pattern of growth of a primary diffuse-type adenocarcinoma of the stomach. Some of the cells even have a signet ring appearance
