Diagnostic Pathology, Journal Year: 2025, Volume and Issue: 20(1)

Published: April 24, 2025

Gastric SMARCA4-deficient undifferentiated tumors are rare and have a poor prognosis. We analyzed two cases of gastric with clinicopathologic characteristics, treatment flow-up. Immunohistochemistry was used to evaluate the expression BRG1 (SAMRCA4), SMARCB1 (INI-1), CKpan, Ki-67, CD3, CD20, CD163, PD-1, PD-L1 in tumors. Additionally, clinical imaging features, diagnosis, were analyzed. Two elderly male patients (69 61 years old) large ulcerated mass located fundus cardia. Histologically, tumor is low adhesion, diffusely infiltrating lamellar growth, without any percentage epithelial differentiation zones, little stromal component. Tumor cells round, oval, small amount irregular shape, easy see mitotic figures. Some them had obvious nucleoli, few multiple nucleoli. The cytoplasm varies, some more abundant. Significant vascular neural invasion. BRG1(SMARCA4) absent, INI-1 present, Ki-67 proliferation index highly expressed (≥ 80%). remaining sarcoma-specific markers negative. In case 1, negative combined positive score 5. 2, CKpan weakly only dozen cells, PDL1 CPS 10. received chemotherapy anti-PD1 immunotherapy after radical gastrectomy for cancer. postoperative follow-up time 16 (case 1) 3 months 2), respectively. general condition good, no recurrence or metastasis observed, plasma normal range. Large likely massive necrosis on surface, leading biopsy results. This has diffuse growth needs be differentiated from variety similar morphology, such as lymphoma, malignant melanoma, neuroendocrine carcinoma sarcoma. slightly increases difficulty pathological diagnosis this disease. However, loss (SMARCA4) can confirm diagnosis. Chemotherapy may potential benefits management given rarity these limited number our study, further research larger cohorts needed validate preliminary

Language: Английский