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<p class="ql-align-justify">Sections show a focal, minimally represented proliferation of atypical epithelial cells arranged in small solid nests and discohesive single cells; these cells exhibit marked pleomorphism, hyperchromasia, and an increased nuclear-to-cytoplasmic ratio, consistent with a poorly differentiated adenocarcinoma. The surrounding gastric mucosa exhibits moderate glandular atrophy and a moderate chronic inflammatory infiltrate composed of lymphocytes and plasma cells within the lamina propria. Neutrophils are seen actively infiltrating the glandular epithelium, indicating moderate activity. Areas of intestinal metaplasia are also present. No H. pylori organisms are identified.</p>
<p>Epigastric pain. Endoscopy: a large mass located at the proximal stomach-gastric cardia.</p>
<p>Multiple small soft tissue fragments collectively measured 1 cm, totally embedded.</p>
<p><strong><em><u>Stomach, cardia, biopsy:</u></em></strong></p><ul><li><strong>Minimally represented (only one fragment), poorly differentiated adenocarcinoma, grade 3.</strong></li><li><strong>Associated H. pylori-associated moderate chronic atrophic gastritis. </strong></li></ul>
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