, Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyung Bin Kim We report a rare case of gastric adenocarcinoma with enteroblastic differentiation (GAED) that was treated with endoscopic submucosal dissection followed by additional distal gastrectomy with lymph node dissection. A 67-year-old man underwent endoscopic submucosal dissection for a gastric lesion, which was diagnosed as GAED with submucosal and lymphatic invasion. Histologically, GAED is characterized by a tubulopapillary growth pattern and clear cells that resemble those of the primitive fetal gut. Immunohistochemically, GAED variably expresses oncofetal proteins such as glypican-3, alpha-fetoprotein, and spalt-like transcription factor 4. Despite negative margins, additional gastrectomy with lymph node dissection was performed due to submucosal and lymphatic invasion. No residual tumor or metastasis was detected, and the patient remained disease-free for 2 years before dying from causes unrelated to GAED. Given its aggressive nature, frequent lymphovascular invasion, and high metastatic potential, clinicians should recognize the histopathological diagnosis of this rare tumor and its propensity for aggressiveness.
, Young Ju Kim, Jung Ja Ahn, Bock Hi Woo The purpose of this study is to establish the normal levels of α-fetoprotein in amniotic fluid between 15 and 22 weeks of gestation.
Amniotic fluid Alpha-fetoprotein(AFAFP)levels were measured by enzyme-immunoassy in pregnant women between 15 and 22 weeks of gestation for variety of indication of amniocentesis from October, 1994 to July, 1996 at Mokdong Hospital Ewha Womans University.
The study group was selected from normal karyotype at prenatal genetic diagnosis and no congenital anomaly of fetus.
The normal level of AFAFP was the highest at 16weeks and then it declined gradually as gestational weeks increased. The mean±SD levels of AFAFP from 15 to 22weeks were 16.9±5.7, 20.4±9.8, 13.8±6.8, 10.9±3.0, 8.1±2.3, 6.9±3.9, 5.6±1.6, 4.7±0.6µg/ml respectively, the median levels of AFAFP from 15 to 22weeks were 14.7, 16.2, 12.3, 11.0, 7.8, 5.5, 5.3, 4.8µg/ml, respectively.
We consider that this preliminary data normal AFAFP levels by each gestation weeks can be used as reference value for screening of anomalies or genetic disorder.
, Tae Hun Kim, Kum Hei Ryu, So Yeon Lim, Ju Ho Lee, Shi Nae Lee Hepatoid adenocarcinoma was described by Ishikura in 1985 for the first time. It is a very rare variant of adenocarcinoma characterized by morphological and functional features of hepatocyte differentiation. It is most commonly presented as gastric adenocarcinoma with otherwise unexplained elevation of serum alpha-fetoprotein level. Most of the patients with gastric hepatoid adenocarcinoma were diagnosed in advanced stages having vascular invasion and/or extensive metastasis in liver or lymph nodes. Accordingly, the prognosis of hepatoid adenocarcinoma is dismal. We experienced a typical case of gastric hepatoid adenocarcinoma and described the clinical features.
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