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Pathology of Early Gastric Cardiac Cancer

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Gastric Cardiac Cancer

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Abstract

Early gastric cardiac cancer occurs primarily in elderly populations, frequently as protruding lesions at upper endoscopy. Microscopically, well-moderately differentiated tubular and papillary adenocarcinomas are most common in this cancer but show a variety of growth patterns, which should be distinguished from reparative/reactive changes. The risk of nodal metastasis in early gastric cardiac carcinoma is significantly lower than that in distal gastric non-cardiac carcinoma, even for intramucosal poorly cohesive/signet-ring cell carcinoma. Because of considerable fibromuscular hyperplasia in the gastric cardia, distinction between invasion of early gastric cardiac carcinoma into the muscularis mucosae and invasion into the muscularis propria is critical because of different therapeutic management strategies.

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References

  1. Lauwers GY, Carneiro F, Graham DY, et al. Gastric carcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumours of the digestive system. Lyon: IARC Press; 2010. p. 48–58.

    Google Scholar 

  2. Tajima Y, Nakanishi Y, Yoshino T, et al. Clinicopathologic study of early adenocarcinoma of the gastric cardia: comparison with early adenocarcinoma of the distal stomach and esophagus. Oncology. 2001;61:1–9.

    Article  CAS  PubMed  Google Scholar 

  3. Huang Q, Fang C, Shi J, et al. Differences in clinicopathology of early gastric carcinoma between proximal and distal location in 438 Chinese patients. Sci Rep. 2015;5:13439. https://doi.org/10.1038/srep13439.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Huang Q, Shi J, Sun Q, et al. Clinicopathologic characterization of small (≤ 2 cm) proximal and distal gastric carcinomas in a Chinese population. Pathology. 2015;47:526–32.

    Article  CAS  PubMed  Google Scholar 

  5. Cestari R, Villanacci V, Bassotti G, et al. The pathology of gastric cardia: a prospective, endoscopic, and morphologic study. Am J Surg Pathol. 2007;31(5):706–10.

    Article  PubMed  Google Scholar 

  6. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20(10):1161–81.

    Article  CAS  PubMed  Google Scholar 

  7. Reis CA, David L, Correa P, et al. Intestinal metaplasia of human stomach displays distinct patterns of mucin (MUC1, MUC2, MUC5AC, and MUC6) expression. Cancer Res. 1999;59(5):1003–7.

    PubMed  CAS  Google Scholar 

  8. Abadir A, Streutker C, Brezden-Masley C, Grin A, Kim YI. Intestinal metaplasia and the risk of gastric cancer in an immigrant Asian population. Clin Med Insights Gastroenterol. 2012;5:43–50.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Aida J, Vieth M, Shepherd NA, et al. Is carcinoma in columnar-lined esophagus always located adjacent to intestinal metaplasia?: a histopathologic assessment. Am J Surg Pathol. 2015;39(2):188–96.

    Article  PubMed  Google Scholar 

  10. Huang Q, Fan X, Agoston AT, et al. Comparison of gastro-oesophageal junction carcinomas in Chinese versus American patients. Histopathology. 2011;59(2):188–97.

    Article  PubMed  Google Scholar 

  11. Al-Haddad S, Chang AC, De Hertogh G, et al. Adenocarcinoma at the gastroesophageal junction. Ann N Y Acad Sci. 2014;1325:211–25.

    Article  PubMed  Google Scholar 

  12. El-Zimaity HM, Ramchatesingh J, Saeed MA, Graham DY. Gastric intestinal metaplasia: subtypes and natural history. J Clin Pathol. 2001;54(9):679–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Schneider NI, Plieschnegger W, Geppert M, et al. Pancreatic acinar cells—a normal finding at the gastroesophageal junction? Data from a prospective Central European multicenter study. Virchows Arch. 2013;463(5):643–50.

    Article  PubMed  Google Scholar 

  14. Rugge M, Correa P, Dixon MF, et al. Gastric dysplasia: the Padova international classification. Am J Surg Pathol. 2000;24(2):167–76.

    Article  CAS  PubMed  Google Scholar 

  15. Schlemper RJ, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Schlemper RJ, Kato Y, Stolte M. Review of histological classifications of gastrointestinal epithelial neoplasia: differences in diagnosis of early carcinomas between Japanese and Western pathologists. J Gastroenterol. 2001;36(7):445–56.

    Article  CAS  PubMed  Google Scholar 

  17. Park DY, Srivastava A, Kim GH, et al. Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. Am J Surg Pathol. 2008;32(4):524–33.

    Article  PubMed  Google Scholar 

  18. Park DY, Srivastava A, Kim GH, et al. CDX2 expression in the intestinal-type gastric epithelial neoplasia: frequency and significance. Mod Pathol. 2010;23(1):54–61.

    Article  CAS  PubMed  Google Scholar 

  19. Lee SE, Kang SY, Cho J, et al. Pyloric gland adenoma in Lynch syndrome. Am J Surg Pathol. 2014;38(6):784–92.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Cameron AJ, Carpenter HA. Barrett’s esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study. Am J Gastroenterol. 1997;92(4):586–91.

    PubMed  CAS  Google Scholar 

  21. Zhang XQ, Huang Q, Goyal K, Odze R. DNA Ploidy Abnormalities in basal and superficial regions of the crypts in Barrett’s esophagus and associated neoplastic lesions. Am J Surg Pathol. 2008;32(9):1327–35.

    Article  PubMed  Google Scholar 

  22. Kim A, Ahn SJ, Park DY, et al. Gastric crypt dysplasia: a distinct subtype of gastric dysplasia with characteristic endoscopic features and immunophenotypic and biological anomalies. Histopathology. 2016;68(6):843–9.

    Article  PubMed  Google Scholar 

  23. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49.

    Article  CAS  PubMed  Google Scholar 

  24. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  25. Yu HP, Fang C, Chen L, et al. Worse prognosis in papillary, compared to tubular, early gastric carcinoma. J Cancer. 2017;8(1):117–23.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Yasuda K, Adachi Y, Shiraishi N, Maeo S, Kitano S. Papillary adenocarcinoma of the stomach. Gastric Cancer. 2000;3:33–8.

    Article  PubMed  Google Scholar 

  27. Lee HJ, Kim GH, Park DY, et al. Is endoscopic submucosal dissection safe for papillary adenocarcinoma of the stomach? World J Gastroenterol. 2015;21:3944–52.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Fang C, Shi J, Sun Q, et al. Risk factors of lymph node metastasis in early gastric carcinomas diagnosed with WHO criteria in 379 Chinese patients. J Dig Dis. 2016;17(8):526–37.

    Article  CAS  PubMed  Google Scholar 

  29. Roh JH, Srivastava A, Lauwers GY, et al. Micropapillary carcinoma of stomach: a clinicopathologic and immunohistochemical study of 11 cases. Am J Surg Pathol. 2010;34(8):1139–46.

    Article  PubMed  Google Scholar 

  30. Hattori T, Sentani K, Hattori Y, Oue N, Yasui W. Pure invasive micropapillary carcinoma of the esophagogastric junction with lymph nodes and liver metastasis. Pathol Int. 2016;66(10):583–6.

    Article  PubMed  Google Scholar 

  31. Wang X, Ouyang H, Yamamoto Y, et al. Residual embryonic cells as precursors of a Barrett’s-like metaplasia. Cell. 2011;145(7):1023–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Lee HH, Hur H, Jung H, Jeon HM, Park CH, Song KY. Analysis of 151 consecutive gastric submucosal tumors according to tumor location. J Surg Oncol. 2011;104(1):72–5.

    Article  PubMed  Google Scholar 

  33. Abraham SC, Krasinskas AM, Hofstetter WL, Swisher SG, Wu TT. “Seedling” mesenchymal tumors (gastrointestinal stromal tumors and leiomyomas) are common incidental tumors of the esophagogastric junction. Am J Surg Pathol. 2007;31(11):1629–35.

    Article  PubMed  Google Scholar 

  34. Min YW, Park HN, Min BH, Choi D, Kim KM, Kim S. Preoperative predictive factors for gastrointestinal stromal tumors: analysis of 375 surgically resected gastric subepithelial tumors. J Gastrointest Surg. 2015;19(4):631–8.

    Article  PubMed  Google Scholar 

  35. Idema DL, Daryanani D, Sterk LM, Klaase JM. Collision tumor of the stomach: a case of an adenocarcinoma and a gastrointestinal stromal tumor. Case Rep Gastroenterol. 2008;2(3):456–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Grin A, Streutker CJ. Neuroendocrine tumors of the luminal gastrointestinal tract. Arch Pathol Lab Med. 2015;139:750–6.

    Article  CAS  PubMed  Google Scholar 

  37. Melton SD, Genta RM. Gastric cardiac polyps: a clinicopathologic study of 330 cases. Am J Surg Pathol. 2010;34(12):1792–7.

    Article  PubMed  Google Scholar 

  38. Zbuk KM, Eng C. Hamartomatous polyposis syndromes. Nat Clin Pract Gastroenterol Hepatol. 2007;4:492–502.

    Article  CAS  PubMed  Google Scholar 

  39. Howe JR, Mitros FA, Summers RW. The risk of gastrointestinal carcinoma in familial juvenile polyposis. Ann Surg Oncol. 1998;5:751–6.

    Article  CAS  PubMed  Google Scholar 

  40. Burmester JK, Bell LN, Cross D, Meyer P, Yale SH. A SMAD4 mutation indicative of juvenile polyposis syndrome in a family previously diagnosed with Menetrier’s disease. Dig Liver Dis. 2016;48(10):1255–9.

    Article  CAS  PubMed  Google Scholar 

  41. Lunca S, Porumb V, Velenciuc N, Ferariu D, Dimofte G. Giant solitary gastric Peutz-Jeghers polyp mimicking a malignant gastric tumor: the largest described in literature. J Gastrointestin Liver Dis. 2014;23(3):321–4.

    PubMed  Google Scholar 

  42. Giardiello FM, Brensinger JD, Tersmette AC, et al. Very high risk of cancer in familial Peutz-Jeghers syndrome. Gastroenterology. 2000;119:1447–53.

    Article  CAS  PubMed  Google Scholar 

  43. Shaco-Levy R, Jasperson KW, Martin K, et al. Morphologic characterization of hamartomatous gastrointestinal polyps in Cowden syndrome, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Hum Pathol. 2016;49:39–48.

    Article  PubMed  Google Scholar 

  44. Wood LD, Noë M, Hackeng W, et al. Patients with McCune-Albright syndrome have a broad spectrum of abnormalities in the gastrointestinal tract and pancreas. Virchows Arch. 2017;470(4):391–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Franzin G, Novelli P. Gastritis cystica profunda. Histopathology. 1981;5:535–47.

    Article  CAS  PubMed  Google Scholar 

  46. Lee HJ, Lee TH, Lee JU, et al. Clinical features of gastritis cystica profunda in patients without history of gastric surgery. Gastric cancer patients vs. non-cancerous patients. Korean J Med. 2006;71:511–7.

    Google Scholar 

  47. Xu G, Peng C, Li X, et al. Endoscopic resection of gastritis cystica profunda: preliminary experience with 34 patients from a single center in China. Gastrointest Endosc. 2015;81(6):1493–8.

    Article  PubMed  Google Scholar 

  48. Choi MG, Jeong JY, Kim KM, et al. Clinical significance of gastritis cystica profunda and its association with Epstein-Barr virus in gastric cancer. Cancer. 2012;118(21):5227–33.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA

    Qin Huang

  2. Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA

    Qin Huang

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  1. Harvard Medical School/Brigham and Women’s Hospital, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts, USA

    Qin Huang

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Huang, Q. (2018). Pathology of Early Gastric Cardiac Cancer. In: Huang, Q. (eds) Gastric Cardiac Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-79114-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-79114-2_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-79113-5

  • Online ISBN: 978-3-319-79114-2

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