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男性,73岁。以“上消化道出血,原因待查”住院。体检剑突下压痛明显。粪潜血(++)。X线钡餐及胃镜诊断胃角区溃疡。胃镜活检4块组织,只一块的胃粘膜间质见印戒细胞。其胞浆PAS强阳性,CEA及角蛋白阳性。病理诊断印戒细胞癌。胃大部切除标本经详尽病理检查,再未找到癌组织,胃周淋巴结阴性。最后诊断:胃角印戒细胞型“一点癌”。讨论胃粘膜“一点癌”(One Point Carcinoma of GastricMucosa,OPCGM)首由中国医科大学1984年提出,罕见。南京鼓楼医院41085例胃镜活检仅发现1例,至今国内14个单位联合报告25例,印戒细胞癌仅1例。OPCGM因其微小能钳取干净,或残留的少许癌组织被胃液消化,因而在切除标本中不见癌组织。胃镜检
Male, 73 years old. With “upper gastrointestinal bleeding, causes unknown” hospitalized. Physical examination of thoracic tenderness is obvious. Fecal occult blood (++). X-ray barium meal and gastroscopy diagnosis of gastric ulcer. Gastroscopy biopsy 4 pieces of tissue, only a piece of gastric mucosal interstitial see signet ring cells. Its cytoplasmic PAS is strongly positive, CEA and keratin are positive. Pathological diagnosis signet ring cell carcinoma. Subtotal gastrectomy specimens were subjected to thorough pathological examination. No cancerous tissue was found. Perigastric lymph nodes were negative. The final diagnosis: signet ring cell type “a little cancer.” Discussion of the “One Point Carcinoma of Gastric Mucosa” (OPCGM) was first proposed by the Chinese Medical University in 1984 and is rare. Only 1 case of gastroscope biopsy was found in 41085 cases of Nanjing Drum Tower Hospital. To date, 25 cases have been reported jointly by 14 units in China, and only 1 case has signet-ring cell carcinoma. OPCGM is not removed from the resection specimen due to its tiny forceps to remove it, or the residual cancer tissue is digested by gastric juice. Gastroscopy