Skip to main content
SpringerLink
Log in

Immunohistochemical study of mucin expression in periampullary adenomyoma

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background/purpose

Benign tumors and tumor-like conditions in the ampullary area are uncommon, and there are extremely rare cases of adenomyoma (AM) and adenomyomatous hyperplasia (AMH). Surgical treatment is necessary if these lesions cause biliary obstruction. In addition, the differential diagnosis of AM and AMH from carcinoma is often difficult by standard endoscopic biopsy and cytopathological analysis that may show differential findings, resulting in unnecessary surgeries sometimes being performed.

Methods

Immunohistochemical (IHC) analysis of periampullary AM and AMH was performed.

Results

For both types of lesions, epithelial glandular cells (EGCs) showed diffuse expression of MUC6 and focal expression of HIK1083, mainly in the inner region, and focal expression of MUC5AC, mainly at the surface. The EGCs showed no expression of MUC1 or MUC4, both of which were identified as malignant tumor markers in our previous series of mucin expression studies in pancreatobiliary tumors. The expression of CK7, which was diffusely positive in normal periampullary mucosa, was decreased in the EGCs of AM and AMH.

Conclusions

A combined evaluation of IHC findings may be effective in the detection of AM and AMH, and also in distinguishing benign periampullary lesions, such as AM and AMH, from ampulla of Vater adenocarcinoma, thus avoiding excessive surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Albores-Saavedra J, Henson DE, Klimstra DS. Adenomyomatous hyperplasia and “adenomyoma”. In: Rosai J, Sobin LH, editors. Tumors of the gallbladder, extrahepatic bile ducts, and ampulla of Vater. Washington, D.C.: Armed Forces Institute of Pathology; 1998. p. 348.

    Google Scholar 

  2. Handra-Luca A, Terris B, Couvelard A, Bonte H, Flejou JF. Adenomyoma and adenomyomatous hyperplasia of the Vaterian system: clinical, pathological, and new immunohistochemical features of 13 cases. Mod Pathol. 2003;16:530–6.

    Article  PubMed  Google Scholar 

  3. Kayahara M, Ohta T, Kitagawa H, Miwa K, Urabe T, Murata T. Adenomyomatosis of the papilla of Vater: a case illustrating diagnostic difficulties. Dig Surg. 2001;18:139–42.

    Article  PubMed  CAS  Google Scholar 

  4. Yonezawa S, Sato E. Expression of mucin antigens in human cancers and its relationship with malignancy potential. Pathol Int. 1997;47:813–30.

    Article  PubMed  CAS  Google Scholar 

  5. Hollingsworth MA, Swanson BJ. Mucins in cancer: protection and control of the cell surface. Nat Rev Cancer. 2004;4:45–60.

    Article  PubMed  CAS  Google Scholar 

  6. Moniaux N, Escande F, Porchet N, Aubert JP, Batra SK. Structural organization and classification of the human mucin genes. Front Biosci. 2001;6:1192–206.

    Article  Google Scholar 

  7. Kitamura H, Yonezawa S, Tanaka S, Kim YS, Sato E. Expression of mucin carbohydrates and core proteins in carcinomas of the ampulla of Vater: their relationship to prognosis. Jpn J Cancer Res. 1996;87:631–40.

    PubMed  CAS  Google Scholar 

  8. Horinouchi M, Nagata K, Nakamura A, Goto M, Takao S, Sakamoto M, et al. Expression of different glycoforms of membrane mucin (MUC1) and secretory mucin (MUC2, MUC5AC and MUC6) in pancreatic neoplasms. Acta Histochem Cytochem. 2003;36:443–53.

    Article  CAS  Google Scholar 

  9. Tamada S, Shibahara H, Higashi M, Goto M, Batra SK, Imai K, et al. MUC4 is a novel prognostic factor of extrahepatic bile duct carcinoma. Clin Cancer Res. 2006;12:4257–64.

    Article  PubMed  CAS  Google Scholar 

  10. Osako M, Yonezawa S, Siddiki B, Huang J, Ho JJ, Kim YS, et al. Immunohistochemical study of mucin carbohydrates and core proteins in human pancreatic tumors. Cancer. 1993;71:2191–9.

    Article  PubMed  CAS  Google Scholar 

  11. Shibahara H, Tamada S, Higashi M, Goto M, Batra SK, Hollingsworth MA, et al. MUC4 is a novel prognostic factor of intrahepatic cholangiocarcinoma-mass forming type. Hepatology. 2004;39:220–9.

    Article  PubMed  CAS  Google Scholar 

  12. Yamashita K, Yonezawa S, Tanaka S, Shirahama H, Sakoda K, Imai K, et al. Immunohistochemical study of mucin carbohydrates and core proteins in hepatolithiasis and cholangiocarcinoma. Int J Cancer. 1993;55:82–91.

    Article  PubMed  CAS  Google Scholar 

  13. Higashi M, Yonezawa S, Ho JJ, Tanaka S, Irimura T, Kim YS, et al. Expression of MUC1 and MUC2 mucin antigens in intrahepatic bile duct tumors: its relationship with a new morphological classification of cholangiocarcinoma. Hepatology. 1999;30:1347–55.

    Article  PubMed  CAS  Google Scholar 

  14. Tamada S, Goto M, Nomoto M, Nagata K, Shimizu T, Tanaka S, et al. Expression of MUC1 and MUC2 mucins in extrahepatic bile duct carcinomas: its relationship with tumor progression and prognosis. Pathol Int. 2002;52:713–23.

    Article  PubMed  Google Scholar 

  15. Yonezawa S, Horinouchi M, Osako M, Kubo M, Takao S, Arimura Y, et al. Gene expression of gastric type mucin (MUC5AC) in pancreatic tumors: its relationship with the biological behavior of the tumor. Pathol Int. 1999;49:45–54.

    Article  PubMed  CAS  Google Scholar 

  16. Buisine MP, Devisme L, Degand P, Deschodt E, Gosselin B, Copin MC, et al. Developmental mucin gene expression in the gastroduodenal tract and accessory digestive glands. II. Duodenum and liver, gallbladder, and pancreas. J Histochem Cytochem. 2000;48:1667–76.

    PubMed  CAS  Google Scholar 

  17. Park HU, Kim JW, Kim GE, Bae HI, Crawley SC, Yang SC, et al. Aberrant expression of MUC3 and MUC4 membrane-associated mucins and sialyl Le(x) antigen in pancreatic intraepithelial neoplasia. Pancreas. 2003;26:48–54.

    Article  Google Scholar 

  18. Paulsen FP, Varoga D, Paulsen AR, Corfield A, Tsokos M, et al. Prognostic value of mucins in the classification of ampullary carcinomas. Hum Pathol. 2006;37:160–7.

    Article  PubMed  CAS  Google Scholar 

  19. Zhou H, Schaefer N, Wolff M, Fischer HP. Carcinoma of the ampulla of Vater: comparative histologic/immunohistochemical classification and follow-up. Am J Surg Pathol. 2004;28:875–82.

    Article  PubMed  Google Scholar 

  20. Chu PG, Schwarz RE, Lau SK, Yen Y, Weiss LM. Immunohistochemical staining in the diagnosis of pancreatobiliary and ampulla of Vater adenocarcinoma: application of CDX2, CK17, MUC1, and MUC2. Am J Surg Pathol. 2005;25:359–67.

    Google Scholar 

  21. Wickstrom C, Christersson C, Davies JR, Carlstedt I. Macromolecular organization of saliva: identification of ‘insoluble’ MUC5B assemblies and non-mucin proteins in the gel phase. Biochem J. 2000;351:421–8.

    Article  PubMed  CAS  Google Scholar 

  22. Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000;13:962–72.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported in part by Grants-in-Aid for Scientific Research on Priority Areas 20014022 (S. Yonezawa) and Scientific Research (C) 20590345 (S. Yonezawa), and 21590399 (M. Higashi), from the Ministry of Education, Science, Sports, Culture and Technology, Japan, and by USPHS grant CA 78590 from the National Institutes of Health (S. K. Batra). The authors thank Dr. Dallas M. Swallow and Dr. Suzanne Crawley for their kind supply of anti-MUC3 antibody, and valuable discussion.

Author information

Author notes

  1. Karine Rousseau

    Present address: Wellcome Trust Centre for Cell-Matrix Research, Faculty of Life Sciences, University of Manchester, Manchester, UK

Authors and Affiliations

  1. Department of Human Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Michiyo Higashi, Masamichi Goto, Miyuki Saitou & Suguru Yonezawa

  2. Department of Pathology, Kagoshima-shi Medical Association Hospital, 7-1, Kamoike-shinmachi, Kagoshima, Japan

    Takeshi Shimizu

  3. Department of Genetics Evolution and Environment, University College London, London, UK

    Karine Rousseau

  4. Departments of Biochemistry and Molecular Biology, Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, USA

    Surinder K. Batra

Authors
  1. Michiyo Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masamichi Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miyuki Saitou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karine Rousseau
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Surinder K. Batra
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Suguru Yonezawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michiyo Higashi.

About this article

Cite this article

Higashi, M., Goto, M., Saitou, M. et al. Immunohistochemical study of mucin expression in periampullary adenomyoma. J Hepatobiliary Pancreat Sci 17, 275–283 (2010). https://doi.org/10.1007/s00534-009-0176-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-009-0176-5

Keywords

Search

Navigation