Pyloric gland adenoma. EndoTODAY 이준행

[StomachTODAY 054. Pyloric gland adenoma]

Pyloric gland adenoma의 비교적 전형적인 조직소견입니다. 대부분 융기형 병소를 보입니다.

한 review article에서 옮깁니다 (Arch Pathol Lab Med 2015).

Pyloric gland adenomas are rare neoplasms of the gastrointestinal tract. Gastric pyloric gland adenomas have been shown to arise in chronically damaged mucosa. The neoplastic glands have gastric pyloric gland differentiation and have a tightly packed organization with occasional cystic dilatation. The individual cells are cuboidal to columnar, with eosinophilic to amphophilic cytoplasm and either no apical mucin cap or a poorly formed apical mucin cap. The nuclei are round to oval, with occasional prominent nucleoli. Immunohistochemically, the neoplastic cells label with markers of gastric pyloric gland differentiation, including MUC6 and MUC5AC. (foveolar epithelium marker인 MUC5AC와 pyloric gland marker인 MUC6가 둘 다 양성인 점이 특징)

Pyloric gland adenoma의 일부는 autoimmune gastritis와 관련이 있습니다 (Virchows Arch 2003;442:317-21).

[More cases of pyloric gland adenoma]

Stomach, endoscopic submucosal dissection:
Pyloric gland adenoma with high grade dysplasia
1. Location : mid body, greater curvature
2. Gross type : elevated
3. Size of adenoma : (1) longest diameter, 20 mm (2) vertical diameter, 16 mm
4. Resection margin : negative resection margins(N)
A 55 years old male was referred due to a cardia polyp. The initial pathology was "indefinite for dysplasia", and there was a note that "there are slightly crowded glands with equivocal nuclear features of regenerating atypia versus low-grade dysplasia. Close follow up is recommended." Pathology review of the outside slide was "gastric type mucosa showing pyloric gland type adenoma." Endoscopic resection was done.
Pyloric gland adenoma with high grade dysplasia
1. Location : cardia
2. Gross type : elevated
3. Size of adenoma : (1) longest diameter, 10 mm (2) vertical diameter, 6 mm
4. Resection margin : negative resection margins
Pyloric gland adenoma with HGD. 남자 55세 (2022)

[References]

1) EsoTODAY - 십이지장질환 증례토의
2) SmallTODAY - 소장질환 증례토의
3) ColonTODAY - 대장질환 증례토의
4) Dr. Sinn's LiverTODAY - 간질환 증례토의