Gastric adenocarcinoma with enteroblastic differentiation: A rare find.
American Journal of Clinical Pathology
Casestudy: Gastric adenocarcinoma with enteroblastic differentiation (GAED), also called clear cell gastric carcinoma, is a subtype of alpha-fetoprotein (AFP) producing adenocarcinoma. GAED is not a well-documented malignancy. Due to rarity, it is often skipped from the list of gastric adenocarcinoma subtypes. We report a case of Gastric adenocarcinoma with enteroblastic differentiation in a 69-year-old male, who had an endoscopy that revealed an ulcerated, circumferential, malignant-appearing mass at the distal esophagus. The patient then underwent proximal gastrectomy with distal esophagectomy. Received was a portion of the proximal stomach and distal esophagus. On gross examination, a 2.6 cm ulcerated mass was present at the gastroesophageal junction with white, friable, and focally necrotic cut surface. H&E stained slides demonstrated a malignant tumor composed of cuboidal to columnar neoplastic cells with clear cytoplasm and prominent nucleoli. The neoplastic cells were arranged in tubular, solid, and trabecular growth patterns. There were also areas of admixed conventional moderately differentiated adenocarcinoma with overlying glandular dysplasia and focal intestinal metaplasia. Immunohistochemical stains demonstrated tumor positivity for CDX2 (strong) and AFP (focal). Neuroendocrine markers were negative within the tumor. In Conclusion, GAED is a rare malignancy with distinctive clinicopathologic features and associated aggressive behavior. Morphology and immunohistochemical stains are helpful in making the diagnosis of this rare malignancy.
Kumar S, Jabbar K. Gastric Adenocarcinoma with Enteroblastic Differentiation: A Rare Find. American Journal of Clinical Pathology. 2020 Oct 1;154:S65.