▲ Fig. 20 g Fragment of a macrospecimen (strip): stomach wall is thickened due to intramural infiltration over a length of 9 cm (arrows). Histologically, an adenocarcinoma with the signet-ring cell component
D Fig. 21a-d. Female patient B, age 46. Diagnosis: gastric cancer. Complained of weakness and epigastric pain unassociated with meals. Endoscopy: ulcerous defect in middle third of the stomach body. Histolological studies failed to reveal tumor cells. Pain persisted for about 6 months and intensified despite active outpatient treatment. In the absence of improvement, X-ray examination was done. a Stomach X-ray (tight filling, vertical position, anterior projection): ulcer niche in the lower third of the stomach body (arrow) and uneven contour of the lesser curvature in the form of a small depression in the middle third of the stomach body. b Target stomach X-ray (tight filling, vertical position, anterior projection), dosed compression: a flat niche with converging folds in the lower third of the stomach body (arrows).
c Stomach X-ray (double contrast, horizontal position, anterior projection): wall of the lesser curvature is thick and rigid, with converging folds, due to intramural infiltration (arrows). Conclusion: infiltrative-ulcerous cancer of the stomach body. d Endo-photograph: disfigured stomach lumen; the lesser curvature is straightened and rigid, with a rounded ulcer sized at 1 cm, with even, sloping edges. Histologically, a non-differentiated cancer
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