Paneth cell carcinoma of the ampulla of Vater.
We describe a Paneth cell carcinoma arising within the ampulla of Vater in a 64-year-old man. The phenotype of virtually all neoplastic cells was consistent with that of Paneth cells, based on routine morphology and their strong positive immunostaining for lysozyme. Additional widespread positive immunostaining for carcinoembryonic antigen and CA 19.9 supports a totipotential cell as the origin of such neoplastic cells. This case, therefore, represents a true Paneth cell carcinoma, as opposed to inclusion of occasional neoplastic Paneth cells into a poorly differentiated adenocarcinoma. This pattern of differentiation is rare, and predictions regarding its ultimate biological behavior and malignant potential must be guarded.
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pa, USA.
Jorge I
JI
Mora
Julieta E
JE
Barroeta
David A
DA
Bernstein
Juan
J
Lechago
D000230:Adenocarcinoma / Q000175:diagnosis; D014670:Ampulla of Vater / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002277:Carcinoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000473:pathology; D016577:Pancreaticoduodenectomy; D019879:Paneth Cells / Q000737:chemistry / Q000473:pathology*; D039901:Totipotent Stem Cells / Q000737:chemistry / Q000473:pathology
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D009363:Neoplasm Proteins; D009113:Muramidase