Sarcina ventriculi in an Endoscopic Ultrasound-Guided Fine Needle Aspiration of a Perigastric Lymph Node with Metastatic Pancreatic Adenocarcinoma: A Carry-Through Contaminant Bacterial Microorganism from the Stomach

Abstract

Sarcina ventriculi is a rare gram-positive coccus increasingly reported in patients with a history of delayed gastric emptying or gastric outlet obstruction and is sometimes seen in association with emphysematous gastritis and perforation. We report a case of a 67-year-old male who presented with epigastric pain. CT imaging and cholangiopancreatography were concerning for pancreatic neoplasia. Upper endoscopic ultrasound-guided fine needle aspiration cytology of a perigastric lymph node confirmed metastatic adenocarcinoma of pancreatic origin, and cocci arranged in a tetrad fashions characteristic of Sarcina ventriculi were noted. To our knowledge, this is the first reported case of Sarcina ventriculi in an FNA of metastatic pancreatic carcinoma in a perigastric lymph node. These organisms likely represent carry-through contaminants from the transgastric approach of the endoscopic FNA.

Low Expression of miR-491-3p Is Correlated with Lymph Node Metastasis in Gastric Cancer

“…Although LNM was the direct reason for distant metastases, it reflects the biological selection of more aggressive subpopulations showing close relation with local and/or regional recurrence [ 3 , 4 ]. As demonstrated by many researchers, the presence of LNMs is associated with decreased postoperative survival in gastric cancer [ 5 , 6 ], being the most important prognostic factors [ 7 ]. Because the increased rate of early detection in gastric cancer can lead to an improved prognosis, the concentrations on improving patients' quality of life and utilizing minimally invasive treatments have increased [ 8 ].…”

Distal Gastrectomy With Roux-en-Y Reconstruction for a Seriously Dilated Stomach With Gastric Outlet Obstruction Secondary to Sarcina ventriculi: A Case Report

“…Overgrowth is facilitated by concurrent underlying conditions that promote gastric retention, such as diabetic gastroparesis, pyloric stenosis, and gastric surgery [ 5 ]. Obtaining a biopsy for lymphadenopathy with S. ventriculi is important to exclude other causes of the condition, such as malignancy or sarcoidosis [ 6 , 7 ].…”