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Immunohistochemical analysis of pyloric gland adenomas using a series of Mucin 2, Mucin 5AC, Mucin 6, CD10, Ki67 and p53

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Abstract

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.

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Acknowledgement

This manuscript is dedicated to Professor Manfred Stolte on occasion of his 70th birthday. The authors declare no conflict of interest.

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Authors and Affiliations

  1. Institute of Pathology, Klinikum Bayreuth, Preuschwitzerstr. 101, 95445, Bayreuth, Germany

    Michael Vieth

  2. Division of Pathology, National Cancer Center Hospital, Tokyo, Japan

    Ryoji Kushima

  3. Department of Pathology, Shiga University of Medical Science, Otsu, Japan

    Ken-ichi Mukaisho, Rie Sakai, T. Kasami & Takanori Hattori

Authors
  1. Michael Vieth
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  2. Ryoji Kushima
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  3. Ken-ichi Mukaisho
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  4. Rie Sakai
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  5. T. Kasami
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  6. Takanori Hattori
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Corresponding author

Correspondence to Michael Vieth.

Additional information

M. Vieth and R. Kushima share first authorship. MV is supported by a grant of the Japanese Society of Pathology for a scholarship at the Shiga University of Medical Science, Department of Pathology, Ohtsu, Japan.

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Vieth, M., Kushima, R., Mukaisho, Ki. et al. Immunohistochemical analysis of pyloric gland adenomas using a series of Mucin 2, Mucin 5AC, Mucin 6, CD10, Ki67 and p53. Virchows Arch 457, 529–536 (2010). https://doi.org/10.1007/s00428-010-0968-7

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  • DOI: https://doi.org/10.1007/s00428-010-0968-7

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