title: Mitochondrion-rich differentiated adenocarcinomas of the stomach: clinicopathological, immunohistochemical and electron microscopy study of nine cases.
abstract: Pathologic and prognostic data of nine patients with mitochondrion-rich carcinomas (MRC) were compared retrospectively to data of 101 patients with conventional gastric adenocarcinomas. MRC was defined as a tumour composed predominantly, or entirely, of columnar adenocarcinoma cells with eosinophilic cytoplasm and a strong supranuclear immunoreactivity for antimitochondrial antibody. Electron microscopy confirmed supranuclear distribution of mitochondria in MRC while immunostaining pattern was irregular or absent in the remaining 101 cases. MRC exhibited a tubulopapillary or cribriform growth pattern with focal infiltration of neutrophils in the tumour stroma. Prominent necrosis was present including segmental and intraluminal "dirty necrosis", while mitotic and ki-67 proliferative rates were low. MRC showed immunohistochemical findings compatible with gastric differentiation (CK7+/CK20-/CDX-) When MRC were compared with non-MRC carcinomas, tumour size (< 4 cm vs >4 cm, P < 0.01) , frequency of lymph node metastases (11% vs. 80%, P < 0.01), low stage (I, II) at diagnosis (100% vs. 56%, P < 0.01), Goseki's group I (100% vs. 6%, P < 0.01), and better survival (0% vs. 70%, P < 0.01) differed significantly. Our results suggest that MRC of the stomach may be considered a low-grade malignancy with an excellent prognosis.
authors.affiliation: Dipartimento di Patologia Umana, Policlinico Universitario, Messina, Italy. rosariocaruso@tin.it
authors.forename: Rosario A
authors.initials: RA
authors.lastname: Caruso
authors.forename: Patrizia
authors.initials: P
authors.lastname: Napoli
authors.forename: Alberto
authors.initials: A
authors.lastname: Nania
authors.forename: Antonino
authors.initials: A
authors.lastname: Parisi
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Valeria
authors.initials: V
authors.lastname: Zuccalà
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D000368:Aged; D000369:Aged, 80 and over; D000071616:CDX2 Transcription Factor; D005260:Female; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D053554:Keratin-20 / Q000032:analysis; D053552:Keratin-7 / Q000032:analysis; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D008928:Mitochondria / Q000276:immunology / Q000473:pathology* / Q000648:ultrastructure; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure
chemical_list: D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; D053554:Keratin-20; D053552:Keratin-7
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