title: Gastric adenocarcinoma associated with granulomatous gastritis. Case report and review of the literature.
abstract: OBJECTIVE
  We describe the fourth reported case of granulomatous gastritis associated with gastric adenocarcinoma, with a review of the literature and considerations about the prognostic implications of this association.
  
  
  RESULTS
  A 48-year-old woman who had been suffering from gastritis for ten years was admitted to our institute for increasing left epigastric pain associated with vomiting. After an endoscopic biopsy had revealed an ulcerated signet ring cell carcinoma, the patient was submitted to subtotal gastrectomy with regional lymph node dissection. Pathological examination of the resected specimen revealed a superficial signet ring cell carcinoma (early cancer) associated with multiple granulomas. The granulomas, which were observed within the mucosa and the submucosa at the periphery of the carcinoma, were composed of CD68-positive, CD15-negative epithelioid and giant cells of the Langhans type, confirming their true histiocytic nature, and were also extensively found within the dissected lymph nodes. Since no ocular, skin, pulmonary or other gastrointestinal lesions were found and the granulomas were negative for acid-fast and fungal stain, a diagnosis of granulomatous gastritis was made.
  
  
  CONCLUSIONS
  To the best of our knowledge this is the fourth example of gastric adenocarcinoma and granulomatous gastritis. These cases suggest an association between granulomatous gastritis and early gastric cancer.
authors.affiliation: Department of Pathology, Columbus Clinic, Catholic University Sacro Cuore, Rome, Italy. giulio.bigotti@tin.it
authors.forename: Giulio
authors.initials: G
authors.lastname: Bigotti
authors.forename: Antonella
authors.initials: A
authors.lastname: Coli
authors.forename: Paolo
authors.initials: P
authors.lastname: Magistrelli
authors.forename: Maria
authors.initials: M
authors.lastname: De Ninno
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Antonacci
authors.forename: Antonio
authors.initials: A
authors.lastname: Crucitti
authors.forename: Francesco
authors.initials: F
authors.lastname: Federico
authors.forename: Armando
authors.initials: A
authors.lastname: Antinori
authors.forename: Guido
authors.initials: G
authors.lastname: Massi
mesh_terms: D000230:Adenocarcinoma / Q000150:complications*; D003937:Diagnosis, Differential; D020776:Endoscopes, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000209:etiology* / Q000473:pathology; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011379:Prognosis; D013272:Stomach Diseases / Q000209:etiology* / Q000473:pathology; D013274:Stomach Neoplasms / Q000150:complications*; D014839:Vomiting / Q000209:etiology