CYTOLOGIC DIAGNOSIS OF GASTRIC CARCINOMA RELATED TO HISTOLOGIC TYPE

  • 1 January 1977
    • journal article
    • research article
    • Vol. 21  (1) , 48-59
Abstract
In gastric smears obtained by the direct vision fiberoptic brush technique from 78 patients with carcinoma of the stomach, an attempt was made to recognize cytologically the histologic type of the tumor with reference to Lauren''s classification. The cytologic diagnosis of intestinal carcinoma was made in 36/45 positive cases on the basis of an abundant cellularity and the presence of rather large pleomorphic cohesive cells often arranged in sheets with a moderately increased N/C [nuclear/cytoplasmic] ratio. One case of intramucous and 2 of early invasive carcinoma revealed malignant cells which did not differ from those of the advanced cases. In these cases as well as in some of the advanced ones, atypical epithelial cells were found in addition to the malignant ones. These cells could have derived from the histologic areas of atypical hyperplasia of the gastric mucosa surrounding the carcinoma. Fourteen of 15 cases of advanced diffuse carcinoma of the stomach could be cytologically identified on the basis of scanty cellularity and the presence of rather small, monomorphic poorly differentiated cells with a high N/C ratio. The cytologic diagnosis of mixed type carcinoma was made in 2/5 positive cases on the basis of the presence of an admixture of both cell types described above. In 2 cases of the mixed type carcinoma, only intestinal type cells were found. In the smears of 9 cases of intestinal type carcinoma, 1 of which was intramucous, and 1 case of mixed type carcinoma, the tumor cells could not be specified. Thirteen of 78 cases (16.7%) showed negative cytology. The overall accuracy rate was 83.3%. The statistical analysis of a number of cytologic parameters indicated that morphologic differences between type I and Type D carcinomas of the stomach exist and they can be evaluated for differential diagnostic purposes.

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