例1,男,53岁。上腹部间歇性疼痛反复发作3年,近3天疼痛加剧,进食后心窝部有梗噎感,伴黑便,不发热;钡餐X线检查及胃镜均提示“贲门癌”。行贲门癌根治术。次全胃切除标本检查:于贲门部小弯侧有2×1.5×1cm大小的溃疡,边缘稍隆起,底部粗糙,切面灰白色,质硬,胃壁层次不清。镜下:溃疡边缘粘膜、粘膜下层及浅肌层内见大量印戒细胞弥漫浸润(见图1)。溃疡边缘肌层内见两个典型的平滑肌瘤,直径分别为0.4cm和0.8cm,灰白色(见图2)。病理诊断:胃贲门部印戒细胞癌合并微型平滑肌瘤。 例2,男,69岁。上腹部不适伴嗳气十余年,近两月病情加重,纳差,消瘦,偶有黑便;钡餐X线检查于十二指肠降部有两个圆形憩室约2.5×2.5cm;胃镜见一息肉,长径0.8cm。当即在胃镜内行单纯息肉摘除术。镜下:胃息肉见局灶性粘膜内印戒细胞癌。粘膜肌内见一平滑肌瘤,直径0.4cm。 Example 1, male, 53 years old. Repeated onset of epigastric intermittent pain for 3 years, pain intensified in the past 3 days, after the meal, there was a sensation of stenosis in the fossa of the heart, accompanied by black stools, and no fever. The X-ray examination of the barium meal and gastroscope all indicated “cardia cancer.” Cardiac cancer radical surgery. Subtotal gastrectomy specimen examination: There were 2×1.5×1cm ulcers on the small curve side of the fontanelle. The margin was slightly raised, the bottom was rough, the cut surface was gray, hard, and the stomach wall was unclear. Microscopically, a large number of signet ring cells were diffusely infiltrated in mucosal, submucosal, and superficial layers of the ulcer (see Figure 1). Two typical leiomyomas are seen in the muscular layer of the ulcer margin, with diameters of 0.4 cm and 0.8 cm, respectively, and grayish white (see Figure 2). Pathological diagnosis: signet-ring cell carcinoma of gastric cardia with microleiomyoma. Example 2, male, 69 years old. Abdominal discomfort associated with hernia for more than 10 years, aggravated in the last two months, anorexia, weight loss, occasional black stool; barium meal X-ray examination in the descending part of the duodenum with two round diverticulum about 2.5 × 2.5cm; gastroscopy see One polyp, long diameter 0.8cm. The simple polypectomy was performed immediately in the gastroscope. Microscope: gastric polyps, see focal intramucosal signet ring cell carcinoma. A leiomyoma with a diameter of 0.4 cm was seen in the mucous membrane.