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病人女性,67岁。腹胀,因打咯伴黑便半年于2008-11-20入院。胃镜示:胃体占位,胃窦幽门区溃疡。胃镜活检病理:(1)(胃体大弯)恶性肿瘤,免疫组化提示胃间质瘤。(2)(幽门管)符合高级别上皮内瘤(黏膜内癌)。于2008-12-18接受远端胃癌根治术(D2),毕Ⅱ式吻合。术中见肿瘤位于胃体后壁,4.0cm×3.5cm×3.0cm大小,侵犯全层达浆膜;胃角处1.0cm×0.5cm溃疡,未突破浆膜。切除组织镜检:胃体肿块,见间叶性肿瘤,考虑高危险性胃肠间质瘤;胃角处及幽门管取材见黏膜内癌;标本上下切缘、大网膜未见肿瘤组织;幽门下淋巴结(3/4),肝总动脉淋巴结(1/1)见癌转移,幽门上淋巴结(0/1),胃小弯淋巴结(0/
Patient female, 67 years old. Bloating, due to stammer with black then six months in 2008-11-20 admission. Gastroscopy shows: Gastric body occupying, gastric pyloric ulcer. Gastroscopy biopsy pathology: (1) (gastric curvature) malignant tumors, immunohistochemistry prompted gastric stromal tumors. (2) (pyloric tube) in line with high-grade intraepithelial neoplasia (mucosal cancer). On December 12, 2008 to accept radical gastrectomy (D2), completed Ⅱ type anastomosis. Surgery, see the tumor located in the posterior wall of the body, 4.0cm × 3.5cm × 3.0cm size, infiltrating the entire layer of serosa; gastric corner 1.0cm × 0.5cm ulcer, did not break the serosa. Excision of tissue microscopy: Gastric mass, see mesenchymal tumor, consider high-risk gastrointestinal stromal tumors; gastric corner and pyloric tube material see intramucosal cancer; upper and lower edge of the specimen, no omentum tumor tissue; Pyloric lymph nodes (3/4), hepatic artery lymph nodes (1/1), cancer metastasis, pyloric lymph nodes (0/1), gastric small lymph nodes (0 /