case_images: PMC11778090_01
case_images: A and B) Endoscopic findings demonstrating severe stenosis in the prepyloric region of the stomach. (C and D) Demonstrate endoscopic ultrasound findings of localized wall thickening in the prepyloric region of the stomach.
case_images: ac9-12-e01593-g001.jpg
case_images: PMC11778090_01_ac9-12-e01593-g001.jpg
case_images: F1
case_images: A repeat EGD and endoscopic ultrasound (EUS) revealed a localized wall thickening in the prepyloric region mainly within the submucosa (Layer 3) and muscularis propria (Layer 4) (Figure 1), with the gastric wall measuring up to 11 mm in thickness.
case_images: A) 200x, demonstrating a H&E slide showing the basophilic color and cocci tetrad arrangement characteristic of Sarcina ventriculi (black arrow). (B) 200x magnification, demonstrating a H&E slide showing signet ring cell carcinoma features (transparent arrow). H&E, hematoxylin and eosin.
case_images: ac9-12-e01593-g002.jpg
case_images: PMC11778090_01_ac9-12-e01593-g002.jpg
case_images: F2
case_images: Biopsy of peritoneal nodules revealed several foci of metastatic signet ring cell carcinoma (SRC), positive for pan-keratin and CDX2 immunostains, some were even positive for mucicarmine stain and negative for HER2/neu (Figure 2).