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<p class="ql-align-justify">Partially ulcerated gastric and esophageal mucosal fragments infiltrated by an invasive moderately differentiated adenocarcinoma. The tumor is composed of crowded, irregular, and angulated and cribriform glands exhibiting fused and back-to-back architecture with minimal intervening stroma. These neoplastic structures are set within a desmoplastic background and are lined by atypical epithelial cells demonstrating nuclear enlargement, hyperchromasia, pleomorphism, loss of polarity, and prominent nucleoli.</p><p class="ql-align-justify"><strong>Immunostaining was done with appropriate positive and negative controls and revealed:</strong></p><ul><li class="ql-align-justify"><strong>Her2/neu: </strong>Negative score 0.</li><li><strong>Mismatch Repair (MMR) Immunohistochemistry:</strong> Intact nuclear expression of MLH1, PMS2, MSH2, and MSH6 within the neoplastic cells (internal non-neoplastic controls verified).</li></ul><p>Mismatch Repair Proficient (pMMR), demonstrating a low probability of Microsatellite Instability-High (MSI-H) status per CAP guidelines.</p>
<p class="ql-align-justify">Referred block for immunostaining of gastric mucosal biopsy diagnosed as adenocarcinoma elsewhere.</p>
<p>Paraffin block for immunostaining.</p>
<p><strong><em><u>Esophagus and Stomach, Gastroesophageal Junction Biopsy & Immunostaining:</u></em></strong></p><ul><li><strong>Adenocarcinoma, tubular type, moderately differentiated.</strong></li><li class="ql-align-justify"><strong>HER2/neu: </strong>Negative (Score 0), indicating the tumor is not a candidate for anti-HER2 targeted therapy.</li><li class="ql-align-justify"><strong>Mismatch Repair (MMR) Status: </strong>Mismatch Repair Proficient (pMMR), as evidenced by intact nuclear expression of MLH1, PMS2, MSH2, and MSH6, indicating a low probability of Microsatellite Instability-High (MSI-H) status.</li></ul>
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