Oncocytic adenocarcinoma of the rectum arising on a villous adenoma with oncocytic features.
Rectal adenocarcinoma with diffuse oncocytic features is a very rare lesion, having been reported only once in the English literature. We describe a case of oncocytic adenocarcinoma of the rectum, associated with a villous adenoma, arising on a 66-year-old man. On histological examination, the adenocarcinoma was composed of neoplastic glands lined by a strongly eosinophilic, granular epithelium that deeply infiltrated the rectal wall. Some basophilic calcifications were present in the gland lumina. Superficially, a villous adenoma with high-grade dysplasia was evident; adenomatous cells showed focal eosinophilic changes, consisting of a large granular cytoplasm, an oval atypical nucleus, and a prominent nucleolus. Immunohistochemically, neoplastic glands reacted strongly with antimitochondria antibody, carcinoembryonic antigen, cytokeratin 20, p53, and CDX2. Molecular alterations observed in oncocytic changes and their significance with regards to neoplastic transformation are briefly discussed.
Piana
Simonetta
S
Department of Pathology, Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42100 Reggio Emilia, Italy. SIMONETTA.PIANA@ASMN.RE.IT
Asioli
Silvia
S
Foroni
Moira
M
D000230:Adenocarcinoma / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D018253:Adenoma, Villous / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D000071616:CDX2 Transcription Factor; D002272:Carcinoembryonic Antigen / Q000032:analysis; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D053554:Keratin-20 / Q000032:analysis; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D012004:Rectal Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D002272:Carcinoembryonic Antigen; D018398:Homeodomain Proteins; D053554:Keratin-20; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53