A 48 Year Old Japanese Man Who Had Recently Immigrated

Multiple Choice

A 48 year old Japanese man who had recently immigrated to the United States was seen by his local physician for fatigue,weight loss,and "feeling full all the time".Endoscopy revealed an absence of rugal folds,and the stomach was difficult to distend with air,so-called "leather bottle stomach".A biopsy was performed,and a representative section is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A) Amoebiasis
B) Gastric carcinoma
C) Granulomatous inflammation
D) Peptic ulcer
E) Signet ring cell gastric carcinoma,diffuse type