Jia YF, Chen FF, Yang L, Ye YX, Gao YZ, Zhang WY, Yang JL. Early gastric composite tumor comprising signet-ring cell carcinoma and mucosa-associated lymphoid tissue lymphoma: A case report. World J Gastroenterol 2024; 30(38): 4232-4238 [DOI: 10.3748/wjg.v30.i38.4232]
Corresponding Author of This Article
Jin-Lin Yang, MD, Professor, Department of Gastroenterology and Hepatology, University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu 610041, Sichuan Province, China. yangjinlin@wchscu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 14, 2024; 30(38): 4232-4238 Published online Oct 14, 2024. doi: 10.3748/wjg.v30.i38.4232
Early gastric composite tumor comprising signet-ring cell carcinoma and mucosa-associated lymphoid tissue lymphoma: A case report
Yi-Fan Jia, Fei-Fan Chen, Li Yang, Yun-Xia Ye, Yi-Zhu Gao, Wen-Yan Zhang, Jin-Lin Yang
Yi-Fan Jia, Fei-Fan Chen, Li Yang, Jin-Lin Yang, Department of Gastroenterology and Hepatology, University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yun-Xia Ye, Wen-Yan Zhang, Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yi-Zhu Gao, Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Co-first authors: Yi-Fan Jia and Fei-Fan Chen.
Co-corresponding authors: Wen-Yan Zhang and Jin-Lin Yang.
Author contributions: Jia YF and Chen FF contributed equally to manuscript writing and editing, and data collection; they make the equal contribution; Yang L, Ye YX, and Gao YZ contributed to conceptualization and supervision; Yang JL and Zhang WY contributed equally to revise the article and supervision; all authors have read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 82173253.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Lin Yang, MD, Professor, Department of Gastroenterology and Hepatology, University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu 610041, Sichuan Province, China. yangjinlin@wchscu.cn
Received: March 18, 2024 Revised: September 10, 2024 Accepted: September 13, 2024 Published online: October 14, 2024 Processing time: 194 Days and 19.3 Hours
Abstract
BACKGROUND
Composite tumors are neoplasms comprising two distinct, yet intermingling, cell populations. This paper reports a rare phenomenon where early gastric signet-ring cell carcinoma (SRCC) and gastric mucosa-associated lymphoid tissue (MALT) lymphoma coexist within the same lesion.
CASE SUMMARY
A 40-year-old woman presented to the West China Hospital for examination, which revealed a whitish, shallow, and uneven mucosal lesion in the stomach. The lesion was diagnosed as a poorly differentiated adenocarcinoma, including SRCC with atypical lymphoid hyperplasia associated with Helicobacter pylori infection, based on histopathological examination of the biopsy specimen. The lesion was excised using segmental gastrectomy. However, histological examination of the surgical specimen confirmed that it was a poorly differentiated gastric adenocarcinoma with features of SRCC and MALT lymphoma. These two entities were stage I and coexisted in the same lesion.
CONCLUSION
It is uncommon for gastric SRCC and MALT lymphoma to coexist without distinct borders. Surgical resection is effective for these lesions.
Core Tip: This paper reports a rare case of an early composite tumor involving the simultaneous occurrence of gastric signet-ring cell carcinoma (SRCC) and mucosa-associated lymphoid tissue lymphoma. A “composite tumor” is a unique phenomenon that combines two distinct tumor types into a single lesion without clear borders. When signet-ring cells are present in gastric B-cell lymphoma, it is crucial to carefully distinguish between lymphoma-associated signet-ring cell changes and gastric SRCCs. The former exhibits inconspicuous epithelial cell atypia and is mostly negative for p53 on immunohistochemistry, with positive E-cadherin expression, whereas the latter exhibits the opposite pattern.
