Abstract
Paneth cells are identified by their distinctively large eosinophilic cytoplasmic granules normally found in the Lieberkuhn's gland. It is also commonly known that they appear in the intestinal metaplastia of the stomach. But recently there are some reports of paneth cells found in the gastric carcinomas which is still not widely known.
A 67-year-old male patient was diagnosed as early gastric carcinoma by routine endoscopic examination performed in July, 2000. The gastric carcinoma was histopathologically diagnosed as well differentiated adenocarcinoma. Paneth-like tumor cells were found in the gastric carcinoma membrane and was distinctively identified by PTAH and other staining and also by the existence of lysosome. And further investigation revealed that Ki-67 and PCNA was both positively stained in the tumor cells and p-53 was negatively stained.
Domestically gastric carcinoma with paneth-like tumor cells have been reported since 1966 by Sano and since then 40 cases have been reported. A precise study of these cases revealed that 0.3% to 4.1% of the gastric carcinoma were associated with paneth-like tumor cells. Among these 40 cases, 28 cases were early carcinoma against 9 cases of advanced carcinoma. Also classified by their histological type, 29 cases were well differentiated type against only 6 cases of undifferentiated type. Surrounding these carcinoma, intestinal metaplasia were found in 34 cases. These results suggest that gastric carcinoma with paneth-like tumor cells were likely to be found in the early stage of well differentiated carcinoma and has strong relationship to intestinal metaplasia itself. These facts might give a new lead to the histogenesis of well differentiated type gastric carcinoma.
