Gastric carcinoids and their precursor lesions. A histologic and immunohistochemical study of 23 cases

Abstract

A histologic and immunohistochemical study was carried out in 23 unselected nonantral gastric carcinoids and their precursor lesions classified according to Solcia et al. None of the patients showed Zollinger-Ellison syndrome. Two variants of carcinoids showing distinctive pathologic and pathogenetic characteristics were identified on the basis of presence or absence of associated chronic atrophic gastritis type A (A-CAG). Chronic atrophic gastritis type A was found in 19 cases showing either single or multiple neoplasms, tumor extension limited to the mucosa or submucosa, consistent endocrine cell precursor changes in extratumoral mucosa, and consistent hypergastrinemia and/or G cell hyperplasia. Associated precursor lesions were only hyperplastic in all but two cases with single carcinoids whereas they were also dysplastic in all but one case with multiple carcinoids. The four tumors arising in nonatrophic mucosa were all single, more aggressive, and not associated with extratumoral endocrine cell proliferations or with signs of gastrin hypersecretion. Tumor cells were diffusely immunoreactive for chromogranin A and synaptophysin but usually negative for chromogranin B or HISL-19. Scattered serotonin cells were found in ten carcinoids. They were more frequent in infiltrating than in intramucosal tumors as were the less represented pancreatic polypeptide cells whereas the reverse was found for alpha-subunit-containing cells. These results are of relevance for tumor pathogenesis and may provide the rationale for a less aggressive therapeutic approach in the patients.

Genetic alterations in poorly differentiated endocrine carcinomas of the gastrointestinal tract

“…20 In the current study, the following primary antibodies were used in this procedure: anti-Ki-67 (1:50; clone MIB 1; Immunotech, Westbrook, ME); anti-p53 monoclonal antibody (1:50; clone D07; Dako, Glostrup, Denmark); antip16 INK4 monoclonal antibody (1:10; clone 16p07; Neomarkers, Union City, CA); anti-Rb monoclonal antibody (1:25; clone Rb1; Dako); and anti-FHIT polyclonal antibody (1:50; ZR44; Zymed Laboratories, South San Francisco, CA). After microwave antigen retrieval, immunostaining was performed using the streptavidin-biotin kit (LSAB2; Dako) according to the manufacturer's specifications.…”

Neuroendocrine Carcinoma of the Stomach-A Case Report

“…To the best of our knowledge only few cases of neuroendocrine carcinoma of the stomach have been reported in India. It occurs mostly in adults and rare in children and has prelidiction for females [3].…”

Altered Distribution of Metaplastic Paneth, Gastrin and Pancreatic Acinar Cells in Atrophic Gastritic Mucosa with Endocrine Cell Lesions

“…Endocrine cell nodules smaller than 0.5 millimeter in diameter were diagnosed as ECD. When an ECD focus at the beginning biopsy of the patient was present, the biopsy was repeated within a shorter period to evaluate other possible lesions and to eliminate The gastric endocrine cell hyperplasia (ECH) is often seen in cases of chronic atrophic gastritis and pernicious anemia with hypo-or achlorhydria (Black and Haffner 1968;Mendelsohn et al 1987;Berendt et al 1989;Borch 1989;Bordi et al 1991;Rindi et al 1993;D'Adda et al 1994;Bordi et al 1995;Rindi 1995;Solcia et al 1995;Lewin and Appelman 1996). There are only a few cases that were accompanied by primary G-cell hyperplasia, multiple endocrine neoplasia (MEN type-1) or Zollinger-Ellison syndrome (Doumith 1982).…”