Abstract
The diagnosis of gastric carcinoma can be challenging in several situations. Diffuse-type carcinomas can be readily overlooked, especially when inconspicuous tumour cells infiltrate between benign gastric glands and elicit little, if any, stromal response. Metastases, particularly from the breast, bear striking similarities with gastric carcinomas and should always be considered in the differential diagnosis when poorly cohesive tumours develop in women. Benign mimics of diffuse-type adenocarcinoma can also result from artifactual or inflammation-induced disruption of non-neoplastic gastric epithelium. Benign foveolar epithelial cells assume a globoid appearance (i.e., signet ring cell change) when they are not confined to the basement membrane. Tubular adenocarcinomas show glandular crowding, branching, villiform or cribriform growth, and cystically dilated crypts that can simulate regenerative atypia. Rare tumours are extremely well-differentiated with minimal architectural abnormalities and only slight nuclear enlargement. Distinction between primary carcinomas and their potential mimics will be discussed during the presentation.
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