Significance of occult neoplastic cells on tumor metastasis a case report of gastric cancer 英文参考文献.docVIP

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Significance of occult neoplastic cells on tumor metastasis a case report of gastric cancer 英文参考文献.doc

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Significance of occult neoplastic cells on tumor metastasis a case report of gastric cancer 英文参考文献

SatoandMukaiDiagnosticPathology2010,5:14 /content/5/1/14 CASE REPORT OpenAccess Significanceofoccultneoplasticcellsontumor metastasis:acasereportofgastriccancer ShinkichiSato1*,MasayaMukai2 Abstract Background:Occultneoplasticcells(ONCs)arethetumorcellsfloatinginthelymphnodesinuses,distantfrom theprimarytumor,andsupposedtobeoneofmostreliablemarkerofprognosis. Methods:Wereportherethecaseofa52-year-oldwomanwithagastriccancerassociatedbynumerousONCs. Results:Postoperativeexaminationofthestomachdisclosedanadvanced,poorlydifferentiatedadenocarcinoma withfrequentlymphnodemetastases.InadditiontoONCsandoccasionalmicrometastases,focalaggregatesof ONCs,oneofthepossibleintermediatelesionsbetweentheONCsandtheusualmetastases,arealsoobserved. Conclusions:Inthepresentcase,atleastsomeofONCsseemtoformthemicroaggregatesoftumorcellsin lymphnodes,anchorinthesinuses,andgrowuptothelargetumorouslesion.EvenifmostoftheONCswere trappedanddisappearedundertheinfluenceoftumorimmunity,thedetectionofONCscouldbeoneofthe reliablecluestoestimatetheprognosis. Background recurrence/metastasis ofvariousmalignancies hasbeen Levelofmalignancyincancerisdefinedbythespeedof suggested[1-5].Microaggregatesoftumorcellshavealso proliferation and the ability of invasion/recurrence/ beenconsideredasoneofthemostpossiblecauseofthe metastasis,andatleastpartiallydependsonthehistolo- metastasisandareeasilydetectedbyroutineHematoxy- gical typeofprimary tumor. Postoperative pathological lin Eosin (HE) stain, though ONCs are hardly examinationofprimarytumordisclosesthehistological detected. Immunohistochemical technique using the type,degreeofinvasion,lymphaticandvenousinvolve- epithelialmarkermakesiteasytodetectsolitary,floating mentandthelymphnodemetastasis, andthesefactors tumorcellsinthelymphnodesinuses[1-5]. areconsideredtocontributethepossibilityofpostopera- We report here a case of gastric cancer with many tive recurrence/metastasis. Accurate prospect of the ONCsindissected lymp