Extremely well‐differentiated adenocarcinoma of the gastric cardia: A unique case with columnar cells and laminated stones

Kawanowa, Kaori; Kawata, Hirotoshi; Hanatsuka, Kazunobu; Hosoya, Yoshinori

doi:10.1111/j.1440-1827.2004.01769.x

Cited by 12 publications

(13 citation statements)

References 11 publications

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“…3). Some authors have called this type of cancer extremely welldifferentiated adenocarcinoma (EWDA) [24]. In this category, there are small-intestinal-type and gastrictype adenocarcinomas, which may be misinterpreted as intestinal metaplasia and foveolar hyperplasia, respectively, by general pathologists.…”

Section: Very/extremely Well-differentiated Adenocarcinoma (Vwda)mentioning

confidence: 99%

Gastric-type well-differentiated adenocarcinoma and pyloric gland adenoma of the stomach

et al. 2006

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found that gastric carcinomas could be broadly divided into gland-forming adenocarcinomas and poorly differentiated carcinomas, which included signet-ring cell carcinomas. The former were found to retain intestinal features, and the latter tended to disclose a diffusely infiltrative growth pattern; Laurén referred to these as intestinal-type and diffuse-type, respectively, reporting that 53% of his samples were intestinal-type, 33% were diffuse-type, and the remaining 14% were unclassifiable [1].In the differentiated adenocarcinomas, intestinal metaplasia was often seen in the stomach, and intestinaltype cancers were thought to arise from the intestinal metaplasia. On the other hand, diffuse-type cancers did not retain intestinal characteristics, and they were considered to arise in the ordinary gastric mucosa, which was not involved in intestinal metaplasia [2,3]. In the middle of the 1980s, Helicobacter pylori was found to cause chronic active gastritis, and it was suggested that H. pylori played an important role in gastric carcinogenesis. In this respect, a hypothesis was that H. pylori caused chronic active gastritis with intestinal metaplasia, resulting in the development of intestinal-type adenocarcinomas [4,5].However, several studies appeared which described well-differentiated adenocarcinomas arising in nonintestinalized gastric mucosa, and there has been a question whether well-differentiated adenocarcinomas of the stomach were exclusively intestinal type. The recent discovery of MUC genes coding core proteins of mucin has identified the phenotypic expression of gastrointestinal neoplasms [6][7][8]. The disease entity of "gastric-type well-differentiated adenocarcinoma" has recently been accepted, especially in Japan and Europe. This entity has often been a clinicopathological subject of discussion, especially in Japanese journals, because its biological behavior is possibly highly malignant, in spite of the difficulty of making endoscopic and histopathological diagnoses [9,10]. AbstractSince 1985, when gastric-type well-differentiated adenocarcinomas were demonstrated in hyperplastic polyps of the stomach, we have studied phenotypic expression in gastrointestinal epithelial lesions. The recent discovery of MUC genes coding core proteins of mucin has improved research on the phenotypic expression of gastrointestinal neoplasms. The disease entity of gastric-type well-differentiated adenocarcinoma has recently been accepted, especially in Japan and Europe. This entity has often become a clinicopathological subject of discussion, because its biological behavior is possibly highly malignant, in spite of the difficulty in making endoscopic and histopathological diagnoses. Even under these circumstances, the term "gastric adenoma" usually means flat adenoma of the intestinal type. Gastric-type adenomas have been regarded as exceptional until recently. Although gastric-type adenomas could theoretically be classified into foveolar type and pyloric-gland type, foveolar-type adenoma is, in practice, difficult t...

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Section: Very/extremely Well-differentiated Adenocarcinoma (Vwda)mentioning

confidence: 99%

Gastric-type well-differentiated adenocarcinoma and pyloric gland adenoma of the stomach

et al. 2006

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“…5). 22,31,32 Well-differentiated adenocarcinoma of gastric type shows papillary/villous projections in the upper portion (Fig. 5A) and irregular branching/fusion and poorly differentiated type carcinoma component in the middle to deeper portion (Fig.…”

Section: Foveolar Adenomamentioning

confidence: 99%

“…6). [31][32][33] Because the most reliable diagnostic criteria of EWDA of gastric type is deeper invasion and/or metastasis, it is difficult to make a correct diagnosis in biopsy specimen. However, multifocal and repeated biopsies may be useful to recognize more atypical areas suggesting malignancy.…”

Section: Foveolar Adenomamentioning

confidence: 99%

Gastric Adenoma

Ota¹,

Riddell²

2008

Pathology Case Reviews

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Gastric adenoma is defined as "a circumscribed benign neoplasm composed of tubular and/or villous structures lined by dysplastic epithelium." Architecturally, gastric adenomas have been categorized as tubular, tubulovillous, or villous adenoma. By using immunohistochemical staining specific for gastric and intestinal mucins and enzymes, gastrointestinal adenomas can be reclassified based on phenotype. Phenotypically, the majority of gastric adenomas belong to the intestinal type (containing goblet cells, absorptive cells, Paneth cells, and/or columnar cells with various degrees of differentiation). Gastric-type adenomas are predominantly composed of pyloric gland mucous cells (pyloric gland adenoma) or gastric foveolar cells (foveolar-type adenoma). There are clinical and morphologic differences between intestinal-type and gastric-type adenomas. In this review, histology and immunohistochemical characteristics of gastric adenomas are described in relation to cell phenotypes of dysplastic epithelial cells.

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“…A literature search in PubMed revealed only 4 hits referring to adenomas of the cardia. Among those, 2 are case reports on invasive carcinomas, and another report summarizes 6 cases of serrated adenomas [6,7,8]. To the best of our knowledge, a case of a true adenoma at the cardia was described only once by Merlier [9] in 1952.…”

Section: Introductionmentioning

confidence: 99%

True Adenomas of the Cardia: A Case Series of 3 Patients

Bajbouj

Weyhern²,

Becker³

et al. 2008

Digestion

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Background/Aim: True adenomas of the cardia appear to be extremely rare lesions. There are no data on the natural history and histopathological background of these lesions. We report 3 patients with true adenomas of the cardia. Methods and Results: Three patients with polypoid masses at the cardia below the Z-line were submitted to a tertiary referral center for further diagnosis and therapy. In 2 of the 3 cases Barrett’s esophagus with low-grade intraepithelial neoplasia was assumed on the basis of histopathological examination of biopsy specimens taken from the surface of the lesions. Polypectomy was performed in all 3 cases. In 2 of the 3 cases the final histopathological diagnosis of low-grade adenoma of the cardia could only be established after complete removal of the polypoid masses. Conclusions: Adenomas of the cardia can be mistaken for dysplasia arising from Barrett’s esophagus, if the diagnosis is based on endoscopic biopsies only. It is, therefore, reasonable to completely remove any suspicious lesions by endoscopy not only for therapeutic but also for diagnostic reasons.

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Extremely well‐differentiated adenocarcinoma of the gastric cardia: A unique case with columnar cells and laminated stones

Cited by 12 publications

References 11 publications

Gastric-type well-differentiated adenocarcinoma and pyloric gland adenoma of the stomach

Gastric-type well-differentiated adenocarcinoma and pyloric gland adenoma of the stomach

Gastric Adenoma

True Adenomas of the Cardia: A Case Series of 3 Patients

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