44 - Stomach: Cirrhosis

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Rodin Number: 45
E Number: 149
Donor: Howard, Powell and Osler
Date: 1882
Size (H x W cm): 13.5 x 12.5

The specimen consists of a portion of stomach which has been everted to show an irregular mucosa in which the normal rugal folds seen on the right side are effaced on the left. A back view (A) shows residual normal muscle (short arrows); the muscle in the wall on the right side cannot be seen because it has been infiltrated by cancer (long arrows).

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Comment

The appearance suggests poorly differentiated adenocarcinoma (linitis plastica). However, the descriptive card states that microscopic examination showed no evidence of malignancy. The malignant cells seen in linitis plastica are typically present singly or in small clusters and are sometimes difficult to appreciate microscopically; thus, it may be that they were not appreciated by Osler, who could not have had a large experience with this type of gastric carcinoma (the other specimens in the Museum collection are examples of discrete gastric ulcers or masses, which are usually more evident as malignancy on microscopic examination).

The case was presented at the November 9, 1883 meeting of the Montreal Medico-Chiurgical Society (reported in the Canada Medical Surgical Journal 1882, XII: 302), where it was called "fibroid disease of the stomach". Apparently, the specimen was sent to Palmer Howard by a Dr Powell from Ottawa, and subsequently examined by Osler.

 

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