Abstract
A 56-year-old male presented with a gradual onset of in epigastrium three months prior to admission, and a mass in the -neck two weeks prior to admission. Physical examination revealed swelling of a left supraclavicular lymphnode on admission. Laboratory data showed anemia, hypo proteinemia and obstructive liver dysfunction. Biopsy specimens of a left supraculavicular lymphnode revealed metastasized poorly differentiated adenocarcinoma. On upper GI series narrowing and rigidity of the gastric antrum was seen. Numerous fine white nodular lesions scattered in the mucous membrane mainly of the gastric body were seen through gastroscope, which were adenocarcinoma in biopsy. Under the diagnosis of gastric cancer, he was treated with anticancer chemotherapy. Bilateral chylothorax developed later and he died on the 72th hospital day. Autopsy revealed an irregular erosion in the gastric antrum and numerous fine nodular lesions in the gastric body. Proliferation of fiberous tissues of the submucosal layer was not remarkable in a cut surface of the specimen. Histological findings showed undifferentiated adenocarcinoma mainly involving the submucosal layer of the stomach, where tumor embolizm and proliferation in lymph and blood vessels were remarkable.
