Case StudiesGastric carcinoma resembling pancreatic mixed acinar-endocrine carcinoma*
Section snippets
Case report
A 77-year-old Japanese woman presented with a 2-month history of epigastralgia. Gastroenteroscopy revealed a 1.2 × 0.9 cm protruded lesion in the posterior wall of the gastric fundus. Under the clinical diagnosis of an early gastric cancer, an endoscopic mucosal resection was performed. Laboratory data showed no abnormality. Her past history was unremarkable except for cholecystectomy for cholelithiasis and appendectomy for acute appendicitis. Extensive systemic examination, including imaging
Discussion
Histologically, the present gastric tumor was very similar to mixed acinar-endocrine carcinomas of the pancreas.1, 2, 3, 4, 5 It showed acinar structures, cellular polarization in the basal localization of the nuclei, and abundant eosinophilic cytoplasm. Immunohistochemically, the tumor expressed pancreatic enzyme, trypsin, and lipase. The tumor also contained solid and glandular elements. It exhibited Grimelius-positive staining and chromogranin A positivity, indicating neuroendocrine
Acknowledgements
The author thanks Yokihiro Takeuchi, Naoko Yamada, Takashi Honma, and Kuniko Kobayashi for their technical assistance and Michiko Takaki for her preparation of the photographs.
References (12)
- et al.
Mixed acinar-endocrine carcinomas of the pancreas
Am J Surg Pathol
(1994) - et al.
Pancreatic carcinoma with duct, endocrine, and acinar differentiation. A histologic, immunocytochemical, and ultrastructural study
Cancer
(1984) - et al.
Malignant mixed exocrine-endocrine tumor of the pancreas with unusual intracytoplasmic inclusions
Ultrastruct Pathol
(1993) - et al.
Pathology of the Gallbladder, Biliary Tract and Pancreas
- et al.
Tumors of the pancreas, in Atlas of Tumor Pathology, 3rd series, Fascicle 20
- et al.
Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases
Am J Surg Pathol
(1992)
Cited by (31)
Case report: Novel PIK3CA and AXIN1 mutations in acinar cell carcinoma of the stomach arising from pancreatic heterotopia
2021, Human Pathology: Case ReportsGastric mixed adenoneuroendocrine carcinoma: correlation of histologic characteristics with prognosis
2016, Annals of Diagnostic PathologyCitation Excerpt :Anti-p53 were commonly synchronous expressed in the 2 components, but it was not always in the case for E-cadherin which was less frequently expressed in neuroendocrine components (Fig. 2). Thirty-one patients with gastric MANEC in the literature were retrieved (Table S1) [10-34]. For the purpose of revealing the correlation of different histologic subtypes and clinical outcomes, gastric MANECs were divided into 2 groups according to tumor grade of the neuroendocrine component, which were MANECs (AC/NEC) and MANECs (AC/NET).
Acinar neoplasms of the pancreas—A summary of 25 years of research
2016, Seminars in Diagnostic PathologyA case of hyperfunctioning pancreatic mixed adenoneuroendocrine carcinoma (MANEC) arising from ectopic pancreatic tissue in the liver
2014, Radiology Case ReportsCitation Excerpt :Additionally, as demonstrated in this case, a MANEC can arise in other organs with no evidence of pancreatic involvement. Review of the literature illustrated 5 cases arising from the stomach (8–10). It is theorized that pancreatic metaplasia or ectopic pancreatic tissue may account for these extrapancreatic MANECs.
Pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus
2012, Human PathologyCitation Excerpt :4) The tumor derives from pluripotential stem cells in the GEJ region with multiple differentiation capabilities. This hypothesis seems likely and has been suggested by other investigators who observed a mixed pattern of pancreatic exocrine and endocrine differentiations in the same adenocarcinoma [23,24,27-30]. This hypothesis requires the support of solid experimental studies.
Acinar cell carcinoma: A possible diagnosis in patients without intrapancreatic tumour
2011, Digestive and Liver Disease
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Address, correspondence, and reprint requests to Masaharu Fukunaga, Department of Pathology, The Jikei Dáisan Hospital, 4-11-1, Izumihoncho, Komaeshi, Tokyo, 201-8601, Japan.