ABSTRACT
A 55 year-old man was admitted with epigastric pain of one-month duration. We performed an esophagogastroduodenoscopy that showed the presence of a 3 cm sized polypoid mass at the lesser curvature side of the antrum. A biopsy demonstrated the presence of a neuroendocrine carcinoma of the stomach. A subtotal gastrectomy with D2 lymph node dissection was performed and the microscopic features of the resected specimen confirmed the diagnosis of a composite large cell neuroendocrine carcinoma with an adenocarcinoma of the stomach. A gastric neuroendocrine carcinoma is extremely rare and a composite neuroendocrine carcinoma with an adenocarcinoma of the stomach has been rarely reported. We report a case of a gastric composite tumor with an adenocarcinoma and a large cell neuroendocrine carcinoma.
Subject(s)
Adenocarcinoma , Biopsy , Carcinoma, Neuroendocrine , Endoscopy, Digestive System , Gastrectomy , Lymph Node Excision , StomachABSTRACT
Idiopathic bronchiolocentric interstitial pneumonia is one of idiopathic interstitial pneumonia, which has a relatively aggressive course and poor prognosis. It is characterized by diffuse centrilobular nodules radiologically with mainly bronchiolocentric inflammation and fibrosis associated with patchy alveolitis lacking interstitial granuloma histologically. This disorder is a recently classified disease category, and to our knowledge, there is no case report in Korea. We present a case of idiopathic bronchiolocentric interstitial pneumonia. A 62-year-old man presented with exertional dyspnea with a 1 month duration. The radiological findings showed extensive centrilobular lesions at both lungs. The surgical lung biopsy specimen demonstrated a centrilobular inflammatory process with small airway fibrosis and inflammation partially radiating into the interstitium. Therefore, the patient was diagnosed with idiopathic bronchiolocentric interstitial pneumonia. He was treated with immunosuppressants including steroids and azathioprine. However, his symptoms did not improve and he expired 7 months later due to an acute exacerbation of the interstitial pneumonia and probable infectious pneumonia.