Immunohistochemical analysis of pyloric gland adenomas using a series of Mucin 2, Mucin 5AC, Mucin 6, CD10, Ki67 and p53.
A pyloric gland adenoma (PGA) of the stomach was first described in a book chapter in 1976 by Kurt Elster and has been rarely reported in the literature. We expanded the current immunohistochemical data of these adenomas in a detailed series to further analyse the immunhistochemical status of PGA. From 60 patients with PGA with and without adenocarcinomas of the gastrointestinal tract, an immunhistochemical panel of Mucin 2, Mucin 5AC, Mucin 6, CD10, Ki67 and p53 was used to define the expression of these markers. All PGA were positive for Mucin 6 (deep mucoid glands), which they express over the whole lesion up to the surface. Mucin 5AC expression varies from case to case. A transition from gastric to intestinal differentiation can be observed focally as depicted by Mucin 2 and CD10 in 65% of the cases. The gastric corpus mucosa of elderly patients with either Helicobacter pylori gastritis or autoimmune gastritis is highly affected. Almost 47% of all PGA already underwent malignant transformation into adenocarcinoma. Significant immunohistochemical differences could be detected between PGA with and without adenocarcinoma regarding ki67 and p53. The diagnosis of PGA can be confirmed immunohistochemically by staining against apomucin 6 and apomucin 5AC. Focal intestinal differentiation supports the hypothesis that gastric adenocarcinomas can initially develop from carcinomas of the gastric type and transform into intestinal type later on. The high frequency of malignant transformation of PGA underlines its high potential for invasive malignancy.
Vieth
Michael
M
Institute of Pathology, Klinikum Bayreuth, Germany. vieth.lkpathol@uni-bayreuth.de
Kushima
Ryoji
R
Mukaisho
Ken-ichi
K
Sakai
Rie
R
Kasami
T
T
Hattori
Takanori
T
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D000236:Adenoma / Q000378:metabolism* / Q000473:pathology; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002471:Cell Transformation, Neoplastic / Q000378:metabolism / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000096:biosynthesis; D008297:Male; D055271:Mucin 5AC / Q000096:biosynthesis; D055262:Mucin-2 / Q000096:biosynthesis; D015260:Neprilysin / Q000096:biosynthesis; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D055271:Mucin 5AC; D055262:Mucin-2; D016159:Tumor Suppressor Protein p53; D015260:Neprilysin
Pathol Int. 2004 May;54(5):311-21
15086835
Virchows Arch. 1999 Oct;435(4):452-7
10526011
Pathol Int. 1996 May;46(5):333-40
8809879
Virchows Arch. 2000 Dec;437(6):581-90
11193468
Virchows Arch. 1996 Jul;428(4-5):223-7
8764930
Am J Surg Pathol. 1999 Feb;23(2):227-31
9989851
Pathologe. 2010 May;31(3):177-81
20349063
Gastric Cancer. 2006;9(3):177-84
16952035
Am J Surg Pathol. 2009 Feb;33(2):186-93
18830123
Pathologe. 2001 Mar;22(2):97-104
11321735
Pathologe. 1987 May;8(3):138-40
3303008
Pathol Res Pract. 1996 Sep;192(9):963-9; discussion 970-1
8950764
Gynecol Oncol. 1999 Sep;74(3):504-11
10479521
Virchows Arch. 2003 Apr;442(4):317-21
12715167
Int J Cancer. 1993 Dec 2;55(6):904-8
8253526
Pathol Int. 1996 Nov;46(11):908-17
8970203
Virchows Arch. 2001 Jan;438(1):49-56
11213835
Ultrastruct Pathol. 1999 Nov-Dec;23(6):375-81
10626687
Z Gastroenterol. 1989 Apr;27(4):212-7
2543151
Virchows Arch. 2002 Feb;440(2):205-208
11964052