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Histologic features of the tumor. (A) Poorly differentiated mucinous adenocarcinoma (hematoxylin and eosin, ×40). (B) Presence of signet-ring cells proportion >10% (arrow heads) (hematoxylin and eosin, ×100). (C) Lymph node metastasis (six of 24 excised lymph nodes). (D1–D5) Immunohistochemical stains are positive for epidermal growth factor receptor (EGFR), and DNA mismatched repair genes MLH1, MSH2, MSH6, and PMS2 have no defects.
