Gastric epithelial atypia following hepatic arterial infusion chemotherapy

A case of a gastric ulcer with epithelial atypia following hepatic arterial infusion chemotherapy (mitomycin C and 5-fluoro-2'-deoxyuridine) for a metastatic carcinoid tumor in the liver was observed. The gastric ulcer was endoscopically detected about 2 months after the initiation of the hepatic arterial infusion chemotherapy. The gastric epithelial atypia was severe enough to cause erroneous cytologic interpretation of the smear as a carcinoma. The cytologic and histologic appearance of chemotherapy-induced epithelial atypia is described with special emphasis on possible diagnostic pitfalls in gastric cytology.