Endoscopic, macroscopic and pathological images of mucosal tumors with lymph node metastases. Four of 161 patients with mucosal tumors had nodal metastases. All of these patients had signet-ring cell carcinomas with ulceration. The smallest tumor was 10 mm in diameter (Case 1). One patient had non-perigastric nodal metastases along the common hepatic artery (Case 2).