21326              DIFFUSE CARCINOMA OF THE STOMACH

The patient was a woman aged 99 who was admitted to hospital comatose, dehydrated and hypotensive (BP 70/40).  There were crepitations at both lung bases.  She died next day of bronchopneumonia.

The specimen shows a diffuse carcinoma Linitis plastica) involving the entire gastric wall except for the pyloric canal.  There is direct extension into the pancreas posteriorly and into the lesser omentum.  At postmortem there were transcoelomic metastases in the pouch of Douglas.  Histology shows a columnar-celled mucin-producing adenocarcinoma.  In many places the tumour cells line relatively large cystic spaces 1-2 mms in diameter.