Romero Nery, Zegarra Ingrid, Delgado Hugo
Instituto de Patología, Universidad Nacional Mayor de San Marcos. Lima, Perú.
Hospital Nacional Docente Madre Niño San Bartolomé. Lima, Perú.
Rev Gastroenterol Peru. 2017 Apr-Jun;37(2):187-189.
We report a rare case of diffuse type of gastric cancer with signet ring cells in 10 years old boy who was admitted with a 12 months history with weight loss, dysphagia to solids first and to liquids later, anorexia, fatigue, dizziness, vomiting and later, with pain in the left upper quadrant. On examination, he appeared pale, malnourished, with café-au- lait spots over the trunk and extremities. Laboratory tests showed; Hb 7.5 g, albumin 2.62 g, Thevenon positive on stools. Abdominal ultrasound examination showed periaortic masses and diffuse space occupying lesions in the liver. Endoscopic examination of the stomach showed multiple elevated tumor lesions. One located at 3 cm on the subcardial region presented irregular borders, partially eroded, that bleed easily when rubbing its surface. Multiple biopsy samples were taken. They showed a diffuse gastric signet cell type carcinoma of the stomach. Immunohistochemistry was positive to CK 8. The patient died a year later with wide spread metastasis. The boy was born through a normal delivery after a normal pregnancy to a primipara mother. His family history recorded a grandmother aunt dying of gastric cancer.
我们报告了一例罕见的弥漫型胃癌伴印戒细胞的病例，患者为一名10岁男孩，因体重减轻、最初吞咽固体食物困难随后吞咽液体也困难、厌食、疲劳、头晕、呕吐以及后来左上腹疼痛等症状入院，病程长达12个月。检查发现，他面色苍白、营养不良，躯干和四肢有咖啡牛奶斑。实验室检查结果显示：血红蛋白7.5克，白蛋白2.62克，粪便潜血试验呈阳性。腹部超声检查显示主动脉旁有肿块，肝脏有弥漫性占位性病变。胃镜检查显示胃内有多个隆起的肿瘤病变。其中一个位于贲门下方3厘米处，边界不规则，部分糜烂，擦拭其表面时容易出血。采集了多个活检样本。结果显示为弥漫型胃印戒细胞癌。免疫组化检查CK 8呈阳性。该患者一年后因广泛转移死亡。该男孩为初产妇母亲正常妊娠后顺产出生。他的家族史记载有一位祖母和一位阿姨死于胃癌。
