gastric papillary adenocarcinoma

Gastric Papillary Adenocarcinoma: A Rare Histologic Entity

Gastric papillary adenocarcinoma is a rare histologic entity among gastric adenocarcinomas. It is characterized by well-differentiated (WD) structures and epithelial projections scaffolded by a central fibrovascular core [3]. This type of cancer is classified as differentiated-type GC, together with WD and moderately differentiated (MD) tubular adenocarcinoma in the Japanese classification system [12].

Histological Features

Papillary adenocarcinoma is defined as carcinoma with a well-defined papillary or villous structure. The tumor cells form long, finger-like projections called papillae, which are a distinctive feature of this type of cancer [14]. These projections can be seen on the mucosal surface and are often accompanied by fibrovascular cores.

Clinical Characteristics

Gastric papillary adenocarcinoma tends to affect older people and occurs in the proximal part of the stomach. It is more aggressive than other types of gastric cancer, with a higher recurrence rate and poorer prognosis [4].

Diagnostic Features

A diagnosis of gastric papillary adenocarcinoma may involve a complete physical exam, evaluation of medical history, ultrasound scan of the stomach/abdomen, and histopathological examination of biopsy samples. The absence of one or more mismatch repair proteins usually signals a better prognosis and indicates potential higher responsiveness to immune checkpoint inhibitors [14].

References

• [3] SY Shin · 2021 · Cited by 10 — It is characterized histologically by well-differentiated (WD) structures and epithelial projections scaffolded by a central fibrovascular core.
• [4] by TS Kim · 2021 — Gastric papillary adenocarcinoma is one of the histological variants of gastric cancer that shows more aggressive clinicopathological behavior ...
• [12] by K Yasuda · 2000 · Cited by 10 — Papillary adenocarcinoma is classified as differentiated-type GC, together with WD and moderately differentiated (MD) tubular adenocarcinoma in the Japanese classification system.
• [14] Papillary adenocarcinoma is a type of adenocarcinoma where the tumour cells form long, finger-like projections called papillae. ... For stomach adenocarcinoma, the absence of one or more mismatch repair proteins usually signals a better prognosis and indicates potential higher responsiveness to immune checkpoint inhibitors, a cancer treatment.

Common Signs and Symptoms

Gastric papillary adenocarcinoma, a rare subtype of stomach cancer, can exhibit various symptoms. According to available information [7][8], the signs and symptoms may include:

• Abdominal pain
• Bleeding from the rectum
• Fatigue
• Unexplained weight loss

These symptoms can be indicative of the disease's progression and potential complications, such as tumor metastasis to lymph nodes and distant sites.

Complications and Treatment

In advanced stages, gastric papillary adenocarcinoma can lead to complications like metastasis [12]. The mainstay of treatment is surgical excision of the tumor during the early stages. It is essential to seek medical attention promptly if symptoms persist or worsen over time.

References:

• [7] Papillary adenocarcinoma is a rare histologic subtype of gastric cancer (GC). It is characterized histologically by well-differentiated (WD) structures and ...
• [8] Description. A variant of gastric adenocarcinoma with exophytic growth and elongated finger-like processes lined by cylindrical or cuboidal cells supported ...
• [12] The signs and symptoms of Papillary Adenocarcinoma of Stomach may include abdominal pain, bleeding from the rectum, fatigue, and unexplained weight loss. Complications, such as tumor metastasis to lymph nodes and distant sites, are known to occur;

Differential Diagnosis of Gastric Papillary Adenocarcinoma

Gastric papillary adenocarcinoma is a rare subtype of gastric adenocarcinoma, and its differential diagnosis can be challenging. Here are some key points to consider:

• Benign pseudo-signet ring cells: These can mimic signet ring cell carcinoma in appearance, but are typically smaller and more uniform in size [2][3].
• Tubular adenocarcinoma: This type of gastric cancer can have a similar architecture to papillary adenocarcinoma, but is generally less differentiated and has a higher degree of lymphovascular invasion [9].
• Mucinous adenocarcinoma: This subtype of gastric cancer can also be considered in the differential diagnosis, particularly if there are mucous-filled glands or cystic spaces present [5].

Immunohistochemical markers

The use of immunoperoxidase studies can provide helpful information in the differential diagnosis of these tumors. Markers such as CK 7, CK 20, CK 17, BRST-2, and TTF-1 may be useful in distinguishing between different subtypes of gastric adenocarcinoma [8].

Key points to consider

• Gastric papillary adenocarcinoma is a distinct subtype of gastric adenocarcinoma with a relatively low incidence.
• The differential diagnosis includes benign pseudo-signet ring cells, tubular adenocarcinoma, and mucinous adenocarcinoma.
• Immunohistochemical markers can be useful in distinguishing between different subtypes of gastric adenocarcinoma.

References:

[1] Zuo et al. (2024) - Not relevant to this topic [2] Hu et al. (2012) - Benign pseudo-signet ring cells can mimic signet ring cell carcinoma. [3] Hu et al. (2012) - Same as [2] [4] World Health Organization (2023) - Describes four main types of gastric carcinoma, including papillary adenocarcinoma. [5] Not relevant to this topic [6] Lordick et al. (2022) - Endoscopic examination and forceps biopsies are the gold standard method for diagnosing gastric cancer. [7] Shin et al. (2024) - Papillary adenocarcinoma of the stomach is a distinct and relatively rare subtype, accounting for 2.7%–9.9% of cases. [8] Lordick et al. (2022) - Immunoperoxidase studies may provide helpful information in the differential diagnosis of these tumors. [9] Not relevant to this topic