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Video Endoscopic Sequence 1 of 8.
Adenocarcinoma of the lesser curvature with signet-ring cells.
This 34 year old female, lawyer, 4 months previously
delivered her second baby and has another baby of three
years, due to an abdominal pain an upper endoscopy was
performed, weight loss of 10 pounds was reported.
For more endoscopic details download the video clips by
clicking on the endoscopic images, wait to be downloaded
complete then press Alt and Enter that you can appreciate
the video in full screen.
All endoscopic images shown in this Atlas contain
video clips.
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Video Endoscopic Sequence 2 of 8.
Chromoendoscopy using Lugol's solution.
At the gastric angle an irregular folders are found.
The image and video display some typical parameters of
criteria of a malign ulcer.
1. Fold tapering
2. Ulcer
3. Fusion of folds
4. Abrupt termination of fold
5. Bulbous enlargement.
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Video Endoscopic Sequence 3 of 8.
In this image and video clip is observed an irregular
ulceration found it at the lesser curvature and the anterior
wall of the stomach which fulfill of criteria of a malign
infiltration.
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Video Endoscopic Sequence 4 of 8.
Another image of the folds that converges in abnormal
form.
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Video Endoscopic Sequence 5 of 8.
Retroflexed Image.
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Video Endoscopic Sequence 6 of 8.
Magnifying Endoscopy 150x.
Some ulcerated areas with neovascularization are observed
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Video Endoscopic Sequence 7 of 8.
Chromoendoscopy using indigo carmin.
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Video Endoscopic Sequence 8 of 8.
Magnifying Endoscopy 150x.
Some ulcerated areas with neovascularization, ulcerated
areas, and cellular agglomerate are seen.
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Video Endoscopic Sequence 1 of 3.
Adenocarcinoma of the lesser curvature with signet-ring cells.
This 56 year-old man, who two months previously initiates
sintomatology with loss weight, satiety and postprandial
vomiting.
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Video Endoscopic Sequence 2 of 3.
In this image and video clip is seen an irregular ulceration
of the body and antrum.
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Video Endoscopic Sequence 3 of 3.
In this image as well as the video clip you can seen another
view of the neoplasia.
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Video Endoscopic Sequence 1 of 3.
In this endoscopic sequence a reflux esophagitis is
observed due to an obstructed gastric cancer of the antrum.
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Video Endoscopic Sequence 2 of 3.
An ulcerated obstructed neoplasia is seen at the gastric antrum.
This 56 year- old male, who presented with early satiety
and postprandial vomiting, suggestive of gastric outlet
obstruction, along with weight loss and anemia. Endoscopy
demonstrated an ulcerated mass.
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Video Endoscopic Sequence 3 of 3.
Biopsy revealed the lesion to be adenocarcinoma
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Video Endoscopic Sequence 1 of 2.
krukenberg´s Tumor.
A 56 year-old female, gynecologist doctor, underwent a
laparotomy due to ovarian tumor, at surgery, a gastric
adenocarcinoma was detected.
F. E. Krukenberg:er das Fibrosarcoma ovarii mucocellulare
(carcinomatodes). Archiv für Gynäkologie,
Berlin, 1896, 50: 287-321. Medline.
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Video Endoscopic Sequence 2 of 2.
The carcinoma proved to be inoperable.
The image and video clip shows the post surgical status.
Only a anastomosis was performed. Both ovaries have
been infiltrated.
In 1896 Krukenberg described what he presumed was a new
type of primary ovarian neoplasm. The true metastatic nature of
this lesion was established six years later. Some 5 – 10% of all
ovarian malignant lesions are regarded as metastatic. Of them
approximately 50% are Krukenberg tumours, which have well
defined histologic characteristics (carcinoma with signet-ring cells
and stroma with sarcomatoid reaction). Krukenberg tumor is
secondary to a neoplastic process in the gastrointestinal tract.
The stomach is the commonest primary site (2% of all women
with gastric cancer develop ovarian metastasis), followed by the
colon. Gallbladder, biliary ducts and appendix can also be the
source of the primary neoplasm.
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Video Endoscopic Sequence 1 of 2.
A 52 year-old female with epigastric pain and vomiting.
No weight loss was reported. The morphological
appearance was that of a big ulcer with suspected
malignancy. However, multiple biopsies of the first
endoscopy did not reveal any malignant cells.
Our recommendation was a repeat the endoscopy in six
week.
Ulcerated Gastric Adeno-Carcinoma at the gastric angle
was found.
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Video Endoscopic Sequence 2 of 2.
Same case as above. The patient did not improve her
symptoms. We had recommended a new endoscopy after
the treatment. The malignant appearance became even
more obvious after two months.
Biopsies of gastric ulcer must be taken at least twice, even
when only an ulcer scar is visible at the second
examination. This is because often the presence of
abundant necrosis causes false negative biopsies.
Click here to see the microscopic images
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Video Endoscopic Sequence 1 of 2.
Ulcerated Adenocarcinoma of the gastric body.
A 79 year-old female who complained of severe epigastric
pain and weight loss of 20 pounds. The video endoscopic
procedure revealed an ulcerated carcinoma of the gastric
body.
All cases shown in this atlas are patients that I have
personally seen in my private practice, where I have
observed a very high incidence of gastric cancer. Patients
of a low socioeconomic status, that are seen at public or
charity hospitals, have an even higher incidence of this
disease.
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Video Endoscopic Sequence 2 of 2.
Bleeding is observed, the ulcerated adenocarcinoma at the
greater curvature.
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Ulcerated Gastric Adenocarcinoma of the gastric incisure.
A 60 year-old female with weight loss and vomiting.
Ulcerated Gastric Adenocarcinoma of the gastric incisure
with signet ring cell.
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Ulcerated Gastric Adeno-Carcinoma.
A 66 year-old male with abdominal pain, nausea,
vomiting and weight loss.
An ulcerated gastric carcinoma at the corpus was found.
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Video Endoscopic Sequence 1 of 2.
A 57 year-old female who had history of a previous upper
gastrointestinal endoscopies over several years,
performed elsewhere. On her visit to our clinic, she
complained of epigastric pain and disuria. A severe urinary
tract infection was detected and ciprofloxacine was
prescribed. The next morning an upper gastrointestinal
endoscopy was performed, a tablet of ciprofloxacine taken
at 3 am, was found at the cardias ( endoscopy was
performed at 9.11 am) The tablet still seen in the
esophagus, which is not considered normal, since food and
medicines travel immediately to the stomach after being
ingested. Therefore, the suspicion of a disease in this
region arises
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Video Endoscopic Sequence 2 of 2.
Ulcerated Gastric Carcinoma of the fundus retroflexed
view.
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Video Endoscopic Sequence 1 of 25.
Adenocarcinoma of the cardias and gastric fundus with signet-ring cells.
A 34 year-old male, who presented dysphagia for solids and liquids.
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Video Endoscopic Sequence 2 of 25.
In the retroflexed image a large ulcerated tumor is observed at the gastric fundus.
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Video Endoscopic Sequence 3 of 25.
The gastric cardias is observed with extensive infiltration.
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Video Endoscopic Sequence 4 of 25.
More images and video clips.
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Video Endoscopic Sequence 5 of 25.
This sequence of images represents the surgical specimen
in our case of gastric cancer
Click on the image to enlarge in a new window
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Video Endoscopic Sequence 6 of 25.
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Video Endoscopic Sequence 7 of 25.
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Video Endoscopic Sequence 8 of 25.
Click on the image to enlarge in a new window
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Video Endoscopic Sequence 9 of 25.
Click on the image to enlarge in a new window
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Video Endoscopic Sequence 10 of 25.
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Video Endoscopic Sequence 11 of 25.
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Video Endoscopic Sequence 12 of 25.
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Video Endoscopic Sequence 13 of 25.
There is an ulcer at the gastroesophageal junction.
The antral mucosa is edematous.
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Video Endoscopic Sequence 14 of 25.
This view shows the irregular border of the ulcer at the esophagogastric junction.
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Video Endoscopic Sequence 15 of 25.
It is shown the fundus of the neoplasia with irregular and
granular surface.
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Video Endoscopic Sequence 16 of 25.
This view shows the irregular border of the ulcer
at the esophagogastric junction.
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Video Endoscopic Sequence 17 of 25.
It is shown the fundus of the neoplasia with irregular and granular surface.
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Video Endoscopic Sequence 18 of 17.
There is a slight malignant epithelial infiltrates into the lamina propria.
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Video Endoscopic Sequence 19 of 25.
It is clearly visible the malignant epithelial cells at the muscular propria.
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Video Endoscopic Sequence 20 of 25.
There are mucosecreting malignant glands.
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Video Endoscopic Sequence 21 of 25.
There are malignant epithelial cells, some of them wit clear cytoplasm.
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Video Endoscopic Sequence 22 of 25.
Picture of a metastatic glandular neoplasia to lymph nodes.
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Video Endoscopic Sequence 23 of 25.
The ring shape of the epithelial malignant cells is the predominant histologic pattern.
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Video Endoscopic Sequence 24 of 25.
Picture of a metastatic glandular neoplasia to lymph nodes.
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Video Endoscopic Sequence 25 of 25.
One year after the surgery a follow up endoscopy was
performed finding this malign nodule at the distal
esophagus.
The patient was re-intervened with distal esophagectomy
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Video Endoscopic Sequence 1 of 19.
Small Gastric Adenocarcinoma of the Diffuse Ring Cell
This 69 year-old female who had been suffered of
epigastric pain since two months, there was no weight loss,
endoscopy was performed found a small and irregular
ulcerated area multiple biopsies were taken.
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Video Endoscopic Sequence 2 of 19.
The endoscopy revealed an irregular ulcer of the posterior wall of the gastric antrum.
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Video Endoscopic Sequence 3 of 19.
Another image of this lesion, multiple biopsies were taken
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Video Endoscopic Sequence 4 of 19.
Biopsies revealed the lesion to be adenocarcinoma.of
diffusely infiltrating, poorly differentiated.
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Video Endoscopic Sequence 5 of 19.
Biopsies revealed adenocarcinoma with signet ring cells.
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Video Endoscopic Sequence 6 of 19.
Gastric adenocarcinoma with signet ring cells.
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Video Endoscopic Sequence 7 of 19.
Alcian Blue Stains Showing Signet Ring Cells.
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Video Endoscopic Sequence 8 of 19.
Positive Cytokeratin
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Video Endoscopic Sequence 9 of 19.
Surgical Specimen
It is noted subtotal gastrectomy specimen found small malignant ulceration
To enlarge the images in a new window click on them
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Video Endoscopic Sequence 10 of 19.
Another image of the tumor
To enlarge the images in a new window pressure on them
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Video Endoscopic Sequence 11 of 19.
Neoplastic infiltration showing the malign ulcer was 1.0 cm
X 1.5 cm.
To Enlarged the image in a new window click on it
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Video Endoscopic Sequence 12 of 19.
To Enlarged the image in a new window click on it
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Video Endoscopic Sequence 13 of 19.
To Enlarged the image in a new window click on it
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Video Endoscopic Sequence 14 of 19.
The depth of infiltration was up to the subserosa but not invading the peritoneum.
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Video Endoscopic Sequence 15 of 19.
To Enlarged the image in a new window click on it
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Video Endoscopic Sequence 16 of 19.
To Enlarged the image in a new window click on it
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Video Endoscopic Sequence 17 of 19.
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Video Endoscopic Sequence 18 of 19.
Cross-section
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Video Endoscopic Sequence 19 of 19.
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Video Endoscopic Sequence 1 of 12.
Adenocarcinoma of the Antrum and incisura angularis
This 73 year-old male presented with one month of epigastric pain.
Endoscopy demonstrated two irregular and ulcerated nodules, the lesion was an adenocarcinoma invasive poorly differentiated of the intestinal type .
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Video Endoscopic Sequence 2 of 12.
There is an irregular and ulcerated nodule in the antrum
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Video Endoscopic Sequence 3 of 12.
Another image and video of the nodule in the antrum
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Video Endoscopic Sequence 4 of 12.
Surgical specimen, showing the neoplasia at the antrum.
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Video Endoscopic Sequence 5 of 12.
Cross Section of the neoplasm
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Video Endoscopic Sequence 6 of 12.
Cross Section of one of the ulcerated nodules
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Video Endoscopic Sequence 7 of 12.
A close up to the ulceration
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Video Endoscopic Sequence 8 of 12.
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Video Endoscopic Sequence 10 of 12.
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Video Endoscopic Sequence 11 of 12.
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Video Endoscopic Sequence 12 of 12.
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