Facharzt FMH Pathologie Practice Questions - Facharzt FMH Für Pathologie Spécialiste FMH En Pathologie Exam

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A total gastrectomy specimen from a 42-year-old woman with a family history of gastric cancer shows diffuse thickening and linitis plastica of the gastric corpus. Microscopic examination reveals non-cohesive, round-to-oval neoplastic cells diffusely infiltrating the muscularis propria as single cells and small loose clusters, with prominent intracytoplasmic mucin vacuoles displacing the nuclei peripherally (signet-ring cell morphology). Glandular/tubular formations are entirely absent. According to the Lauren classification and molecular pathology, which diagnosis and genetic alteration are most characteristic?

Intestinal-type gastric adenocarcinoma; associated with APC and TP53 mutations. Gastric hepatoid adenocarcinoma; characterized by alpha-fetoprotein (AFP) secretion. Diffuse-type gastric adenocarcinoma; associated with germline or somatic CDH1 (E-cadherin) alterations. Gastric glomus tumor; driven by NOTCH2 translocations.

Correct Answer:

Diffuse-type gastric adenocarcinoma; associated with germline or somatic CDH1 (E-cadherin) alterations.

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