This subtotal gastrectomy specimen is from a 40 y/o woman who presented with abdominal pain. Biopsy of a suspicious gastric ulcer showed signet ring cell carcinoma. The ulcer is on lesser curvature. Pyloric margin is to the left. Diffuse subtype of gastric carcinoma (signet ring cell carcinoma) tends to involve prepyloric region more often than other locations within the stomach. Subsequent thickening and rigidity of the gastric wall frequently results in pyloric obstruction. Image Courtesy of : Ed Uthman, MD, Houston, Texas.