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BMJ Case Reports 2017; doi:10.1136/bcr-2017-220421
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A rare case of gastric mixed adenoneuroendocrine carcinoma (MANEC) with gastric Helicobacter pylori-negative mucosa-associated lymphoid tissue (MALT) lymphoma

  1. Ghassan Bachuwa
  1. Hurley Medical Center, Flint, Michigan, USA
  1. Correspondence to Dr Ghassan Bachuwa, gbachuw2{at}hurleymc.com
  1. ↵BK and MO contributed equally.

  • Accepted 17 June 2017
  • Published 14 July 2017

Description

A 47-year-old African-American man presented to the emergency department with upper abdominal pain, nausea and vomiting. His symptoms were aggravated by eating. He reported 32 kg unintentional weight loss over 2 months’ period. Abdominal examination revealed tenderness in the epigastric region. Abdominal CT scan showed mural wall thickening involving the gastric antrum and pylorus (figure 1). Subsequent oesophagogastroduodenoscopy (EGD) revealed a large mass occupying the gastric antrum (figure 2). Initial biopsy from the gastric mass showed poorly differentiated adenocarcinoma.

Figure 1

(A) Coronal section of the CT abdomen with intravenous and oral contrast showing wall thickening at the level of the gastric antrum. (B) Axial section of the CT abdomen with intravenous and oral contrast showing wall thickening at the level of the gastric antrum and pylorus.

Figure 2

Upper gastrointestinal endoscopy showing a mass in the gastric antrum (A. B. C: different views).

The patient underwent partial gastrectomy with gastrojejunostomy and the gastric specimen was examined. There was a transmurally invasive adenocarcinoma that has a remarkable variety of cell types and growth patterns, including tubular, mucinous, …

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