Gastric carcinoma with lymphoid stroma: pathological and immunohistochemical analysis

Nineteen gastric carcinomas with lymphoid stroma were selected from 554 surgical cases and examined pathologically and immunohistochemically using formaldehyde-fixed, paraffin embedded materials. Most showed ulcerative lesion and 15 cases located in fundic and cardiac gland regions. They were subdivided histologically into three groups, early (group I), localized (group II) and infiltrative tumors (group III), the number of cases being 2, 10 and 7, respectively. Lymph node metastases occurred in 3 cases in group II and 6 in group III, the latter showing a significantly higher incidence. The number of carcinoembryonic antigen and CA19-9 immunoreactive tumor cells was apparently smaller in gastric carcinomas with lymphoid stroma than in ordinary gastric carcinomas. Frequent presence of alpha 1-antichymotrypsin immunoreactivity characterized the tumor cells of gastric carcinoma with lymphoid cells. Stroma cells consisted of lymphocytes, plasma cells, granulocytes and histiocytes. Of these, the greatest number examined immunohistochemically was B cells and IgG cells, followed in descending order by T cells, IgA cells and IgM cells in the order given. A variable number of lysozyme immunoreactive histiocytes were also detected in all the cases. Gastric carcinoma with lymphoid stroma might be subclassified as a separate entity, although short term follow-up study did not demonstrate a favorable prognosis for this type of gastric cancer.