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<p class="ql-align-justify">1&2 Ulcerated gastric mucosal fragments by related diffuse sheets of atypical round cell infiltrate with nuclear enlargement and hyperchromasia. Anaplasia is marked and mitosis is active. Areas of signet ring cell differentiation are noted. Background chronic active gastritis with identifiable Helicobacter pylori organisms is observed.</p><p class="ql-align-justify">Possibilities includes poorly cohesive carcinoma with signet ring cell differentiation and non Hodgkin lymphoma.</p><p class="ql-align-justify">To definitively characterize this atypical infiltrate, confirm or rule out malignancy, and establish its exact cellular lineage (e.g., epithelial, lymphoid, or histiocytic), an immunohistochemical panel: Pan-Cytokeratin (CK), CD20, CD3, and CD68 is recommended.</p>
<p class="ql-align-justify">Fungating mass causing severe narrowing and stenosis of the gastric antrum, peripyloric region, and pylorus—highly suspicious for gastric carcinoma.</p>
<p>Two biopsies were received:</p><p class="ql-align-justify">1- Biopsy from fungating mass in a antrum: soft tissue fragments collectively measured 1 cm totally embedded.</p><p class="ql-align-justify">2- Biopsy from prepyloric region: soft tissue fragments collectively measured 1 cm, totally embedded.</p>
<p><strong><em><u>Stomach, endoscopic biopsy: </u></em></strong></p><ul><li><strong>Atypical round cell infiltrate.</strong></li><li><strong>Recommended for typing by marker study. </strong></li></ul>
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