To highlight the significant diagnostic challenges of identifying gastric metastases from invasive lobular carcinoma (ILC) that mimic primary gastric malignancies.
Key Findings:
Signet ring cell morphology in gastric biopsies can mimic primary gastric carcinoma, complicating diagnosis.
An IHC panel incorporating breast-lineage markers (GATA3, TRPS1) and GI markers (CDX2, CK20) is essential for accurate diagnosis to avoid mismanagement.
The patient had a history of ILC and developed gastric symptoms years after initial diagnosis, highlighting the need for vigilance.
Interpretation:
The case illustrates the critical importance of distinguishing between primary gastric cancer and gastric metastases from ILC, particularly when signet ring cell morphology is present, as misdiagnosis can lead to inappropriate treatment.
Limitations:
The study is based on a single case, limiting generalizability and necessitating further research.
Potential for misdiagnosis exists due to overlapping symptoms and histological features, underscoring the need for awareness.
Conclusion:
Signet ring morphology in gastric biopsies is not pathognomonic for primary gastric carcinoma, necessitating careful diagnostic evaluation in patients with a history of ILC to ensure appropriate management.
by Amalia A. Sofianidi, Constantinos Papadimitris, Maria Papanikolaou, Eleftheria Lakiotaki, Penelope Korkolopoulou, Meletios-Athanasios Dimopoulos, Maria Kaparelou
