这些大细胞应该不是上皮细胞，从形态和免疫组化结果来看符合RS细胞。尽管胃腺癌伴有HD少见，但文献中的确有报道，而且还有胃非HD与HD伴发的情况。此例胃是否为腺癌还要核实，另外，胃HD很少见，要除外非HD的少见类型。谢谢分享，等待学习。

We describe the case of a 59-year-old Caucasian male who presented to the outpatient clinic with intractable hiccups, upper abdominal pain, repeated bouts of vomiting, and stiff neck. Physical examination revealed a cachectic male with pallor, with enlarged left supraclavicular Virchow's lymph node and hepatosplenomegaly. Histologic examination of the excised lymph node revealed simultaneous presence of 2 malignant processes, nodular sclerosing classical Hodgkin's lymphoma and metastatic adenocarcinoma. Subsequent investigations of the patient, revealed the presence of gastric adenocarcinoma. Although factors governing the coexistence and the possible order of appearance of the 2 pathologies in the present case remain unknown, attempts are made to elucidate the pathogenetic mechanisms that led to their existence.

 能不能上转胃癌的切片？尽管胃癌伴HD可以有，但罕见 诊断应更慎重；从目前资料看，并不能支持如此诊断。

  胃癌存在，淋巴结有R--S样细胞建议染上皮。胃癌的切片上传。

罕见病例有但证据要充分。还是一原性解释临床好接受！期待你们的结果！