Two histologic types of early gastric carcinoma and their cytologic presentation

A study was made of 119 case of early gastric carcinomas as to age, sex, histologic cell types, depth of penetration of the cancer, metastasis to the regional lymph nodes and cellular changes of the mucosa near the foci of center. Two distinctly different cellular types were identified. One was the intestinal type, and the other was a diffusely infiltrated, mixed-cell type that was termed the "gastric" type. In both sexes, the intestinal type occurred in the older age group while the gastric type was noted in the younger age group. Once the cancer had penetrated through the muscularis mucosae, there was a sudden, increased incidence of metastasis to the regional lymph nodes regardless of the cellular type. While still confined to the mucosae, only one case of early gastric carcinoma, one of the gastric type, had metastasized to the regional lymph nodes. On this histologic basis, cytologic characteristics of two types of gastric carcinoma are summarized, and the importance of their recognition is emphasized.