Expression of integrins in tumour tissue of a patient with cancer of the Vater's ampulla complicated by pancreas divisum.
We present herein a rare case where cancer of the Vater's ampulla was complicated with pancreas divisum. Endoscopic retrograde cholangiopancreatography demonstrated the pancreas divisum and stenosis of the common channel due to the tumorous lesion of the Vater's ampulla. Magnetic resonance cholangiopancreatography demonstrated that the Wirsung duct and Santorini duct were unconnected. The biopsy specimen at the upper gastrointestinal endoscopy revealed moderately differentiated tubular adenocarcinoma. The patient was diagnosed with cancer of the Vater's ampulla complicated with pancreas divisum, and underwent a pylorus-preserving pancreaticoduodenectomy. Immunohistochemical examination showed that the p53 protein and the alpha5beta1-integrin were expressed in tumour cells, and the proliferating cell nuclear antigen test was positive. Furthermore, the alpha5beta1-integrin was expressed in chronic pancreatitis tissue. We demonstrate that there is a risk that pancreas divisum will co-exist with malignant disease in the pancreaticobiliary area, causing a potential risk of complicating malignant diseases in the pancreas.
Sawai
Hirozumi
H
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Japan. cb8h-swi@asahi-net.or.jp
Okada
Yuji
Y
Funahashi
Hitoshi
H
Matsuo
Yoichi
Y
Yamamoto
Minoru
M
Hayakawa
Tetsushi
T
Tanaka
Moritsugu
M
Takeyama
Hiromitsu
H
Manabe
Tadao
T
D000230:Adenocarcinoma / Q000737:chemistry* / Q000473:pathology; D000368:Aged; D014670:Ampulla of Vater / Q000737:chemistry* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000737:chemistry* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D016023:Integrins / Q000032:analysis*; D009363:Neoplasm Proteins / Q000032:analysis*; D010179:Pancreas / Q000002:abnormalities*
D016023:Integrins; D009363:Neoplasm Proteins