case_images: PMC539240_01
case_images: Histomorphologic appearance of the primary gastric carcinoma (A) and a paragastric lymph node metastasis (B). Photomicrograph shows that the primary tumor is mainly composed of solid and tubular formations, whereas, a marked desmoplastic stromal reaction is seen in the lymph node metastasis. (hematoxylin and eosin x 40).
case_images: 1477-7819-2-43-1.jpg
case_images: PMC539240_01_1477-7819-2-43-1.jpg
case_images: F1
case_images: Microscopically, the carcinoma was mainly composed of tubular formations of mitotically active, atypical epithelial cells (Figure 1A). The latter two were mainly observed in paragastric lymph node metastases (Figure 1B).
case_images: Computed tomography of the abdomen four years after Billroth II resection for gastric cancer, revealing an inhomogenous mass in the pancreatic head, 4 cm in diameter. (Picture courtesy the Division of Radiology, German Cancer Research Center, provided by PD Dr. med. S. Delorme).
case_images: 1477-7819-2-43-2.jpg
case_images: PMC539240_01_1477-7819-2-43-2.jpg
case_images: F2
case_images: Four years after gastric resection, however, ultrasound examination, computed tomography and magnetic resonance imaging revealed an inhomogeneous mass of the pancreatic head, measuring 4 cm in largest diameter (Figure 2).
case_images: Histomorphologic appearance of the delayed pancreatic metastasis (hematoxylin and eosin x 100). As in the lymph node metastasis, a marked desmoplastic stromal reaction is seen in the pancreatic metastasis.
case_images: 1477-7819-2-43-3.jpg
case_images: PMC539240_01_1477-7819-2-43-3.jpg
case_images: F3
case_images: Microscopically, the tumor consisted of solid and glandular formations of atypical epithelial cells with distinct nuclear pleomorphism and presented marked desmoplastic stromal reaction, as well as areas of necrosis (Figure 3).