Clinicopathological Characteristics of Gastric-Type Adenoma(Pyloric Gland Adenoma):Endoscopic Findings, Histogenesis, Gene Mutations, and Malignant Transformation Ryoji Kushima 1,2 , Akiko Matsubara 3 , Shigetaka Yoshinaga 4 , Ichiro Oda 4 , Haruhisa Suzuki 4 , Seiichiro Abe 4 , Satoru Nonaka 4 , Hirokazu Taniguchi 5 , Yutaka Saito 4 , Shigeki Sekine 5 1Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Japan 2Center for Cancer Control and Information Services, National Cancer Center, Tokyo 3Department Basic Pathology, National Defense Medical College, Tokorozawa, Japan 4Endoscopy Division, National Cancer Center Hospital, Tokyo 5Pathology Division, National Cancer Center Hospital, Tokyo Keyword: 胃型腺腫 , 幽門腺腺腫 , 内視鏡像 , 細胞分化 , 遺伝子変異 pp.1838-1849
Published Date 2014/12/25
DOI https://doi.org/10.11477/mf.1403200109
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 Twenty consecutive cases of gastric-type adenoma(pyloric gland adenoma)of the stomach(13 males and 7 females ; mean age, 72.1 years)were studied with special reference to the endoscopic, histopathologic, immunohistochemical, and molecular genetic findings. All tumors(average size, 18.2 mm)were located in the fundic gland mucosa of the upper/middle area of the stomach. Endoscopic findings categorized them into four types ;(1)tall villous elevation,(2)smooth surface elevation with constriction,(3)inverted growth, and(4)nodule-aggregating lesion. Nine of the 20 tumors had cancerous foci(high-grade dysplasia). Differentiation to fundic-gland type cells was observed in five tumors. Among the 20 tumors, GNAS and KRAS mutations were detected in 11 and 10 tumors, respectively. The present study clarifies the characteristics of gastric-type adenomas from macroscopic to genetic views and discusses their malignant transformation and clinical management.

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