Pyloric Gland Adenoma

Chen, Zong-Ming; Scudiere, Jennifer R.; Abraham, Susan C.; Montgomery, Elizabeth A.

doi:10.1097/pas.0b013e31817d7ff4

Cited by 144 publications

(56 citation statements)

References 13 publications

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“…Moreover, most gastric cancers in LS patients were of gastric mucin phenotype. Given that PGA is a gastric-type adenoma,21 our findings also support PGA as one of the precursor lesions of gastric cancer in LS.…”

Section: Discussionsupporting

confidence: 74%

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Pyloric Gland Adenoma in Lynch Syndrome

Lee¹,

Kang²,

Cho³

et al. 2014

American Journal of Surgical Pathology

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The prevalence of gastric cancer associated with Lynch syndrome (LS) is highly variable, and the underlying histologic pathway or molecular mechanisms remain unclear. From 1995 to 2012, 15 patients had been treated for both gastric and colonic adenocarcinomas and diagnosed as LS. In all cases, pathologic review, immunohistochemical analysis for mismatch-repair proteins, and microsatellite instability (MSI) tests were performed. To confirm LS, germline mutation tests and multiplex ligation-dependent probe amplification were performed. All gastric and colonic carcinomas were MSI-high and lost expressions of MLH1/PMS2 in 11 (73%) cases and MSH2/MSH6 in 4 (27%) cases. Remarkably, in a patient with LS and germline mutation of MLH1 gene, pyloric gland adenoma (PGA) transformed to adenocarcinoma during follow-up. In 2 additional cases, PGA was found adjacent to advanced gastric cancers. All PGAs in LS patients were MSI-high and lost expression of mismatch-repair proteins (MLH1/PMS2 in 2 cases and MSH2/MSH6 in 1 case), whereas none of the 14 sporadic PGAs was MSI-high or had lost expression of mismatch-repair proteins. On the basis of these observations, although very rare, we suggest the possibility that PGA may be a precursor lesion to gastric adenocarcinoma in LS and that the mismatch-repair deficient pathway of carcinogenesis is involved early in the gastric carcinogenesis pathway.

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Section: Discussionsupporting

confidence: 74%

“…PGA is an uncommon histologic subtype of gastric polyps. Until recently, it was not well established as a distinct entity, especially in the literature from the United States 21,23. PGA occurs more commonly in older women and predominantly in the cardia and fundic mucosa in H. pylori or autoimmune gastritis 21,23,24.…”

Section: Discussionmentioning

confidence: 99%

Pyloric Gland Adenoma in Lynch Syndrome

Lee¹,

Kang²,

Cho³

et al. 2014

American Journal of Surgical Pathology

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“…The accurate diagnosis of the gastric type of NADET, especially pyloric gland adenoma seems to be clinically important, since such lesions have been shown to be at a high risk of higher grade of dysplasia or adenocarcinoma [14]. Previous studies reported that 30–39% of pyloric gland adenomas contained high-grade dysplasia, and 12% of the tumors were associated with adenocarcinoma [24, 25]. More recently, Matsubara et al [26] demonstrated that pyloric gland adenomas in the stomach and in the duodenum were associated with mutations of a distinctive tumor-suppressor gene referred to as GNAS .…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Features and Magnifying Chromoendoscopic Findings of Non-Ampullary Duodenal Epithelial Tumors

et al. 2018

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Background and Aims: We aimed to investigate an association between clinicopathological features, including immunohistochemical mucin phenotypes, and magnifying chromoendoscopic findings with crystal violet staining (ME-CV) in non-ampullary duodenal epithelial tumors (NADETs). Methods: A total of 55 patients with NADET were divided into 3 groups by mucin phenotype: intestinal, gastrointestinal, or gastric. ME-CV findings were classified into 4 patterns: convoluted, leaf-like, reticular/sulciolar, and pinecone. The clinicopathological features and ME-CV findings were compared among the mucin phenotypes. Results: Tumors of the gastric type were located in the duodenal bulb (p < 0.001), and contained pyloric gland adenoma (p < 0.001) more frequently than the other types. White-light endoscopy indicated that milk-white mucosa was less frequent in tumors of the gastric type than in those of the gastrointestinal type (p = 0.006) and the intestinal type (p < 0.001). ME-CV findings were significantly different between the gastric type and the other type (p = 0.028). Totally, 5 of 8 tumors of the gastric type manifested a pinecone pattern, 4 of which were compatible with pyloric gland adenoma. Conclusions: The endoscopic findings of NADETs differ according to mucin phenotype. A pinecone pattern under ME-CV may be characteristic of NADETs of the gastric type, especially pyloric gland adenoma.

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“…In addition, the present case was positive for PAS, differentiated from PGA [16,18]. The dysplastic glands were, however, less reactive to PAS than the surrounding hyperplastic ones, which suggests that the former fairly lost the feature of the original BG to acquire the neoplastic characteristics, such as positivity for MUC5AC.…”

Section: Discussionmentioning

confidence: 87%

“…Some authors insist that PGA is differentiated from BGs [16,17] or BGA [18] on the grounds that, while the former not only expresses MUC6 but MUC5AC, the latter group is stained negative for MUC5AC, but it is the neoplastic BGs that showed positivity for a foveolar mucin marker in the present case, which expressed neither pepsinogen1 nor H + K + -ATPase [3,19]. In addition, the present case was positive for PAS, differentiated from PGA [16,18].…”

Section: Discussionmentioning

confidence: 99%