Abstract
The simultaneous occurrence of all 4 intestinal cell types—goblet, striated border, Paneth and argentaffin cells—is reported in a gastric carcinoma for the first time. This is regarded as indisputable evidence of the intestinal direction of differentiation of this gastric carcinoma. The evolution of accompanying gastric glandular polyps—elongation of gastric foveolae through nuclear atypicality to irregularity of foveolar outline—is followed and the transition from adenoma to carcinoma is illustrated. Anatomic confirmation of clinical reports that gastric mucosal atrophy precedes polyp formation is provided by atrophic glands in the small polyps of this case. It is concluded that intestinalization of the gastric mucous membrane which accompanies atrophic gastritis is, in itself, not a premalignant or preneoplastic change but that the forces acting on the generative zone of the gastric foveolae to produce benign intestinal metaplasia of the stomach may act in the same manner at the inception of a neoplasm.
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