The patient proceeded to endoscopic biopsy:
MACROSCOPIC DESCRIPTION:
- 140cm oes": Viable tan fragments 3x3x1mm in aggregate. A1.
- "Cardiac": Four fragments 1-2mm. A1.
MICROSCOPIC DESCRIPTION:
The biopsies show features of poorly differentiated adenocarcinoma. The tumour forms trabeculae, nests and complex glandular structures. It is surrounded by inflamed stroma. The tumour cells have enlarged hyperchromatic nuclei, prominent nucleoli and moderate amounts of focally vacuolated cytoplasm. There is some mucoid material in the background. No evidence of lymphovascular invasion is seen. A small strip of normal gastric mucosa is present. The tumour cells are diffusely CK20 and CDX-2 positive with very focal CK7 positivity. P504S is negative.
DIAGNOSIS: Poorly differentiated adenocarcinoma.