The University of Pittsburgh Medical Center
Department of Pathology
Surgical Pathology Report
SP Number: S97-00000
Hospital Number 000-00-0000
Name: Spock, Mister
Date of Birth: 00/00/0000
Report Type: Surgical Pathology Telereport
Patient Status: Consultation
Accession Date: 00/00/97
 Pathologist: Eric Schubert MD
Clinician: Dr McCoy
Referring Pathologist: Dr Quincy
Referring Institution: Central Hospital



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PATIENT HISTORY: The patient is a 70 year old white male with stomach ache, decreased appetite and 10 lb. weight loss over two months. Endoscopy revealed a gastric mass. The patient is status post septoplasty and removal of throat nodule.
PRE-OP DIAGNOSIS: Gastric lesion.
POST-OP DIAGNOSIS: Gastric lesion.
PROCEDURE: Total gastrectomy.
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Requisition
FINAL DIAGNOSIS:
PARTS 1AND 2: STOMACH, TOTAL GASTRECTOMY -
A. MENETRIER'S DISEASE (SEE COMMENT).
B. AREAS OF MULTIFOCAL SUPERFICIAL ACUTE ULCERATION.
C. THREE LYMPH NODES WITH NO SPECIFIC PATHOLOGICAL DIAGNOSIS.
D. NO MALIGNANCY SEEN.
PART 3: STOMACH, PROXIMAL MARGIN -
A. GASTRIC MUCOSA WITH SLIGHT CYSTIC DILATATION.
B. NO MALIGNANCY SEEN.

COMMENT: The histologic features consisting of marked foveolar hyperplasia replacing parts of the fundal and body gastric mmucosa are consistent with a diagnosis of Menetrier's disease. Menetrier's disease should also have a clinical correlative component including hypoproduction of gastric acid and protein loss. Thereis no evidence of lymphoma or carcinoma.

SDF/sdf

Pathologist--Sydney Finkelstein, M.D.
Resident--Gail Deutsch, M.D.
** Report Electronically Signed Out ** By Pathologist--Sydney Finkelstein, M.D. 03/06/95 09:50

My electronic signature above is attestation that I have personally reviewed the gross specimen(s) and/or glass slides of the submitted material(s) and that the above diagnosis reflects this evaluation.
GROSS DESCRIPTION:
Gastric Resection Hyperplastic Folds Polypoid Mucosa Mucosa Close Up
The specimen is received unfixed in three parts.

Part 1 is labeled "gastric tumor" and consists of a 3.0 x 1.8 x 1.1 cm. mass of pink-tan tissue which has a polypoid flowering appearance of the mucosa throughout with very little muscularis mucosa present. The lesion is submitted in its entirety in cassette 1A frozen, 1B-1D.

Part 2 is labeled "stomach" and consists of a gastric resection without pylorus or gastroesophageal junction, total specimen measuring 19.0 x 29.0 x 1.0 cm. The entire mucosal surface with the exception of the antrum which measures 9.0 cm. is carpeted by pink-tan, hyperplastic folds which is contiguous and confined to the mucosal surface. In some areas the mucosa has a flowery polypoid appearanceThe mucosa of the antrum is pink tan with decreased rugal folds. The serosa is pink-tan and smooth with minimal fibrous adhesions. Few lymph nodes are identified in the peri iliac adipose tissue measuring from 0.8 to 1.5 cm. Sections are submitted as follows:
2A - lymph nodes
2B - proximal margin
2C-F - representative sections of hyperplastic epithelium
2GH - sections of antrum with adjacent lesion.

Part 3 is labeled "proximal margin" and consists of a fragment of pink-tan mucosa measuring 2.0 x 1.2 x 0.4 cm. The specimen is submitted in its entirety in cassette 3A.

GHD/mpp

INTRAOPERATIVE CONSULTATION:

1A: TUMOR, GASTRIC, BIOPSY (Frozen section) -
A. BENIGN.
B. MENETRIER'S DISEASE VERSUS HYPERPLASTIC POLYP. NO EVIDENCE OF LYMPHOMA, CARCINOMA, OR ADENOMA.
(S. Finkelstein/G. Deutsch)
mpp
Sydney Finkelstein, M.D.
Gail Deutsch, M.D.

MICROSCOPIC:
Thickened Mucosa Focal Atrophy Focally Dilation Pseudo-invasion No Dysplasia
Microscopic examination reveals a markedly thickened mucosa with hyperplasia (folveolar) and cyst formation. In addition, there is focal atrophy of the gastric glands. In some areas the gastric pits extend all the way down to the muscularis mucosa, and are focally dilated with mucus. Focal areas of pseudo-invasion through the muscularis mucosa are seen. While there is significant architectural distortion, there is no dysplasia. Nor is there any substantial inflammatory component.
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HISTO TISSUE SUMMARY:
Part Block Sect.Site Stains/Proceedures
1 4 - FR
2 8 - RHHEx18
3 1 -
** END OF REPORT ** MISTER SPOCK S97-00000