Virchows Archiv

, Volume 446, Issue 5, pp 537–541

Pyloric gland adenoma arising in Barrett’s esophagus with mucin immunohistochemical and molecular cytogenetic evaluation

  • Ryoji Kushima
  • Michael Vieth
  • Ken-ichi Mukaisho
  • Rie Sakai
  • Hidetoshi Okabe
  • Takanori Hattori
  • Horst Neuhaus
  • Franz Borchard
  • Manfred Stolte
Case Report

Abstract

Pyloric gland adenoma is a recently described and very rare entity. The occurrence of adenoma is very unusual in Barrett’s epithelium of the esophagus. We report a case of esophageal polyp showing the features of pyloric gland adenoma, which was surrounded by so-called specialized columnar epithelium. Immunohistochemically, most tumor glands were strongly positive for MUC6, except in the superficial layer. MUC5AC was positive in almost all tumor cells, but MUC2 and CD10 were negative in the tumor. MIB-1-positive proliferating cells were distributed throughout the tumor. Microdissection and comparative genomic hybridization analyses revealed losses on 2p24–25.2, 2q14.1-ter, 5q31.3–32, 6q23–24, 8q23–24.2, 11q22.3–24 and 18q21.1–22. This is the first case of pyloric gland adenoma found to arise in Barrett’s epithelium of the esophagus, showing its unstable and precancerous nature.

Keywords

Pyloric gland adenoma Barrett’s epithelium Esophagus Mucin CGH 

References

  1. 1.
    Bakotic BW, Robinson MJ, Sturm PD, Hruban RH, Offerhaus GJ, Albores-Saavedra J (1999) Pyloric gland adenoma of the main pancreatic duct. Am J Surg Pathol 23:227–231Google Scholar
  2. 2.
    Borchard F, Ghanei A, Koldovsky U, Hengels KJ, Bückmann FW (1990) Gastrale Differenzierung in Adenomen der Magenschleimhaut. Immunohistochemische und elektronenmikroskopische Untersuchungen. Verh Dtsch Ges Pathol 74:528Google Scholar
  3. 3.
    Elster K (1976) Histologic classification of gastric polyps. In: Morson BC (ed) Pathology of the gastro-intestinal tract. Springer, Berlin Heidelberg New York, pp 78–92Google Scholar
  4. 4.
    Glickman JN, Shahsafaei A, Odze RD (2003) Mucin core peptide expression can help differentiate Barrett’s esophagus from intestinal metaplasia of the stomach. Am J Surg Pathol 27:1357–1365Google Scholar
  5. 5.
    Haggitt RC, Tryzelaar J, Ellis FH, Colcher H (1978) Adenocarcinoma complicating columnar epithelium-lined (Barrett’s) esophagus. Am J Clin Pathol 70:1–5Google Scholar
  6. 6.
    Hameeteman W, Tytgat GN, Houthoff HJ, van den Tweel JG (1989) Barrett’s esophagus: development of dysplasia and adenocarcinoma. Gastroenterology 96:1249–1256Google Scholar
  7. 7.
    Itoi T, Takei K, Shinohara Y, Takeda K, Nakamura K, Horibe T, Sanada A, Ohno H, Matsubayashi H, Saito T, Watanabe H (1999) K-ras codon 12 and p53 mutations in biopsy specimens and bile from biliary tract cancers. Pathol Int 49:30–37Google Scholar
  8. 8.
    Kallioniemi OP, Kallioniemi A, Piper J, Isola J, Waldman FM, Gray JW, Pinkel D (1994) Optimizing comparative genomic hybridization for analysis of DNA sequence copy number changes in solid tumors. Genes Chromosomes Cancer 10:231–243Google Scholar
  9. 9.
    Kamitani S, Sugihara H, Shiomi H, Tani T, Hattori T (2000) Intratumoral regional variations in copy number of the chromosomal part revealed by microdissection and combined ploidy and comparative genomic hybridization analyses in esophageal squamous cell carcinoma. Cancer Genet Cytogenet 132:30–35Google Scholar
  10. 10.
    Kato N, Akiyama S, Motoyama T (2002) Pyloric gland-type tubular adenoma superimposed on intraductal papillary mucinous tumor of the pancreas. Pyloric gland adenoma of the pancreas. Virchows Arch 440:205–208Google Scholar
  11. 11.
    Kushima R, Remmele W, Stolte M, Borchard F (1996) Pyloric gland type adenoma of the gallbladder with squamoid spindle cell metaplasia. Pathol Res Pract 192:963–969Google Scholar
  12. 12.
    Kushima R, Borchard F, Hattori T (1997) A new aspect of gastric metaplasia in Crohn’s disease: bidirectional (foveolar and pyloric) differentiation in so-called “pyloric metaplasia” in the ileum. Pathol Int 47:416–419Google Scholar
  13. 13.
    Kushima R, Manabe R, Hattori T, Borchard F (1999) Histogenesis of gastric foveolar metaplasia following duodenal ulcer: a definite reparative lineage of Brunner’s gland. Histopathology 35:38–43Google Scholar
  14. 14.
    Kushima R, Rüthlein HJ, Stolte M, Bamba M, Hattori T, Borchard F (1999) “Pyloric gland-type adenoma” arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type. Virchows Arch 435:452–457Google Scholar
  15. 15.
    Michal M, Curik R, Matler K, Benes Z (2003) Regarding the paper by Vieth et al. Virchows Archiv 442/4:317–321. Virchows Arch 443:589–590Google Scholar
  16. 16.
    Shiroshita H, Watanabe H, Ajioka Y, Watanabe G, Nishikura K, Kitano S (2004) Re-evaluation of mucin phenotypes of gastric minute well-differentiated-type adenocarcinomas using a series of HGM, MUC5AC, MUC6, M-GGMC, MUC2 and CD10 stains. Pathol Int 54:311–321Google Scholar
  17. 17.
    Takei K, Watanabe H, Itoi T, Saito T (1996) p53 and Ki-67 immunoreactivity and nuclear morphometry of “carcinoma-in-adenoma” and adenoma of the gall-bladder. Pathol Int 46:908–917Google Scholar
  18. 18.
    Thurberg BL, Duray PH, Odze RD (1999) Polypoid dysplasia in Barrett’s esophagus: a clinicopathologic, immunohistochemical, and molecular study of five cases. Hum Pathol 30:745–752Google Scholar
  19. 19.
    Tokugawa T, Sugihara H, Tani T, Hattori T (2002) Modes of silencing of p16 in development of esophageal squamous cell carcinoma. Cancer Res 62:4938–4944Google Scholar
  20. 20.
    Torres C, Antonioli D, Odze RD (1998) Polypoid dysplasia and adenomas in inflammatory bowel disease: a clinical, pathologic, and follow-up study of 89 polyps from 59 patients. Am J Surg Pathol 22:275–284Google Scholar
  21. 21.
    Tsukashita S, Kushima R, Bamba M, Sugihara H, Hattori T (2001) MUC gene expression and histogenesis of adenocarcinoma of the stomach. Int J Cancer 94:166–170Google Scholar
  22. 22.
    van Dekken H, Alers JC, Riegman PH, Rosenberg C, Tilanus HW, Vissers K (2001) Molecular cytogenetic evaluation of gastric cardia adenocarcinoma and precursor lesions. Am J Pathol 158:1961–1967Google Scholar
  23. 23.
    Varis A, Puolakkainen P, Savolainen H, Kokkola A, Salo J, Nieminen O, Nordling S, Knuutila S (2001) DNA copy number profiling in esophageal Barrett adenocarcinoma: comparison with gastric adenocarcinoma and esophageal squamous cell carcinoma. Cancer Genet Cytogenet 127:53–58Google Scholar
  24. 24.
    Vieth M, Kushima R, Borchard F, Stolte M (2003) Pyloric gland adenoma: a clinico-pathological analysis of 90 cases. Virchows Arch 442:317–321Google Scholar
  25. 25.
    Walch AK, Zitzelsberger HF, Bruch J, Keller G, Angermeier D, Aubele MM, Mueller J, Stein H, Braselmann H, Siewert JR, Hofler H, Werner M (2000) Chromosomal imbalances in Barrett’s adenocarcinoma and the metaplasia-dysplasia-carcinoma sequence. Am J Pathol 156:555–566Google Scholar
  26. 26.
    Watanabe H, Jass JR, Sobin LH (1990) Histological typing of oesophageal and gastric tumours. Springer, Berlin Heidelberg New YorkGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Ryoji Kushima
    • 1
  • Michael Vieth
    • 2
  • Ken-ichi Mukaisho
    • 3
  • Rie Sakai
    • 1
  • Hidetoshi Okabe
    • 1
  • Takanori Hattori
    • 3
  • Horst Neuhaus
    • 4
  • Franz Borchard
    • 5
  • Manfred Stolte
    • 2
  1. 1.Division of Diagnostic PathologyShiga University of Medical ScienceShigaJapan
  2. 2.Institute of PathologyKlinikum BayreuthBayreuthGermany
  3. 3.Department of PathologyShiga University of Medical ScienceShigaJapan
  4. 4.Department of General Internal MedicineEvangelisches Krankenhaus DüsseldorfDüsseldorfGermany
  5. 5.Institute of PathologyKlinikum AschaffenburgAschaffenburgGermany

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