Histopathological Classification of Nonantral Gastric Endocrine Growths in Man

Solcia, Enrico; Bordi, Cesare; Creutzfeldt, W.; Dayal, Yogeshwar; Dayan, Anthony D.; Falkmer, Sture; Grimelius, Lars; Havu, Niilo

doi:10.1159/000199786

Cited by 325 publications

(198 citation statements)

References 16 publications

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“…The percentage in whom these carcinoids are invasive is unclear and there are poor guidelines regarding in whom gastric resections should be done. The number of patients with gastric carcinoids in our study may be an underestimation as it currently is unclear whether all gastric carcinoids are associated with mucosal changes or even with advanced precarcinoid lesions described in the Solcia classification [92]. At present we are following these patients endoscopically and with endoscopic ultrasound.…”

Section: Management Of Gastric Carcinoids In Patients With Men-1 and Zesmentioning

confidence: 87%

Management of the Zollinger–Ellison syndrome in patients with multiple endocrine neoplasia type 1

Jensen¹

1998

Journal of Internal Medicine

175

169

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Zollinger-Ellison syndrome (ZES) is the most common symptomatic pancreatic endocrine tumour in patients with MEN-1. Besides the treatment of the usual endocrinopathies seen in patients with MEN-1, the treatment of the ZES requires attention be paid to controlling the gastric acid hypersecretion, to dealing with the gastrinomas per se which are malignant in 18-60% of cases, and to the diagnosis and treatment of gastric carcinoid tumours, that are increasingly seen in these patients. In this article the current management of each of the areas is reviewed and what is known or uncertain discussed, based on our studies at the NIH and data from others. Data from 231 patients including 45 with MEN-1 and 186 without MEN-1 is contrasted in this report. Gastric acid hypersecretion has been controlled in all patients medically with MEN-1 and ZES at the NIH for up to 22 years. The current drugs of choice are H ϩ -K ϩ ATPase inhibitors and twice a day dosing is recommended. Periods of parenteral drug therapy (surgery, etc.) and pregnancy require important modifications. The appropriate surgical therapy of the gastrinoma is controversial. Eighty per cent of patients have a duodenal gastrinoma and 20-30% have a pancreatic tumour. Recent studies suggest gastrinoma enucleation combined with duodenotomy rarely results in cure. Aggressive surgery (Whipple resection) can result in cure of gastrinoma but effect on survival is unclear.There are important differences in gastrinoma location, extent, and percentage with aggressive disease in patients with or without MEN-1, which are discussed. Confusion has occurred because of lack of information on the natural history of the gastrinoma compared to the other pancreatic endocrine tumours that occur in MEN-1 and survival data from patients with and without MEN-1 is contrasted. The occurrence of gastric carcinoids in patients with and without MEN-1 with ZES is contrasted and the areas of certainty and disagreement reviewed.

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Section: Management Of Gastric Carcinoids In Patients With Men-1 and Zesmentioning

confidence: 87%

Management of the Zollinger–Ellison syndrome in patients with multiple endocrine neoplasia type 1

Jensen¹

1998

Journal of Internal Medicine

175

169

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“…Personal and clinical data, family history of gastric neoplasia and smoking habit were recorded for all patients during a structured clinical interview [9,18]. Diagnosis of T1-GCs was performed when enterochromaffin-like cell proliferation was [500 l [31], classified according to the 2010 WHO criteria [2].…”

Section: Diagnosis Of Type I Gastric Carcinoid and Atrophic Body Gastmentioning

confidence: 99%

Gastric cancer in patients with type I gastric carcinoids

et al. 2014

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Background Atrophic body gastritis (ABG) is associated with both type I gastric carcinoids (T1-GCs) and intestinaltype gastric cancer. The occurrence of gastric cancer in ABG patients with type I gastric carcinoids has not yet been described. Aim To describe the occurrence at follow-up of gastric cancer in ABG patients with type I gastric carcinoid in a retrospective case series in a single tertiary referral center. Methods Between 1994 and 2012, 17 new cases of T1-GCs were diagnosed among a cohort of ABG patients in a single tertiary referral center for ABG. The clinical charts of these 17 T1-GC patients were retrospectively evaluated for the occurrence of gastric cancer at follow-up (median 4.2 years, range 0.5-13). Results In 4 (23.5 %)/17 T1-GCs patients (3 females, age 40-78 years), gastric cancer occurred (median follow-up 5.9 years, range 5.1-13). Three cases were intestinal-type adenocarcinomas and one a signet-ring cell diffuse gastric cancer, localized in three cases in the antrum. In two patients, it was detected on random biopsies during followup gastroscopy; in the other two, gastroscopy was performed because of new symptoms. All patients with gastric cancer had associated autoimmune features (pernicious anemia, autoimmune thyroid disease and a spared antrum) compared to 77, 46 and 54 % of those without gastric cancer, although statistical significance was not reached. Conclusions This case series shows that in patients with T1-GCs, gastric cancer may frequently occur at long-term follow-up. Thus, these patients should be monitored by a long-term surveillance program, including an accurate bioptic sampling of the antral mucosa.

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“…18 For the purposes of this study, tissue was deemed 'inadequate' if it was poorly oriented, too small, or crushed. Synaptophysin-and chromogranin-immunostained sections 19 were assessed for numbers of endocrine cells according to the system of Solcia et al 9,20 Gastric antral endocrine cells were assessed and graded as: either linear distribution (considered to be normal), nodular distribution or tumour. 19 Gastric body endocrine cells were assessed and graded.…”

Section: Histopathologymentioning

confidence: 99%