Top

Published in:

01-05-2005 | Case Report

Adenoma with gastric differentiation (so-called pyloric gland adenoma) in a heterotopic gastric corpus mucosa in the rectum

Authors: M. Vieth, R. Kushima, J. P. A. de Jonge, F. Borchard, F. Oellig, M. Stolte

Published in: Virchows Archiv | Issue 5/2005

Abstract

In a 46-year-old man, a pedunculated rectal polyp measuring 3.0×3.0×2.0 cm was diagnosed histologically as a pyloric gland-type adenoma arising in heterotopic gastric corpus mucosa. The luminal site was covered by glands of the gastric foveolar type, displaying focal marked proliferation interpreted as low-grade intraepithelial neoplasia. A bidirectional gastric differentiation was found: most lower glandular structures showed positivity for the deep gastric mucin core protein Muc 6 and superficial positivity for gastric foveolar epithelium mucin core protein Muc 5AC. Pyloric gland adenoma has so far been described in one larger series only and a few case reports of the stomach, gallbladder, pancreatic duct and within heterotopic gastric corpus mucosa of the duodenal bulb. The present case report is the first case of a pyloric gland-type adenoma within a gastric corpus heterotopia of the rectal mucosa.

Amaris J (2002) Intraductal mucinous papillary tumor and pyloric gland adenoma of the pancreas. Gastrointest Endosc 56:441–444

Antonietta Pistoia M, Guadagni S, Ventura T, Pistoia F, Carboni M (1986) Gastric heterotopia of the rectum. Endoscopy 18:34

Bakotic BW, Robinson MJ, Sturm PD, Hruban RH, Offerhaus GJ, Albores–Saavedra J (1999) Pyloric gland adenoma of the main pancreatic duct. Am J Surg Pathol 23:227–231

Beck F, Chawengsaksophak K, Waring P, Playford RJ, Furness JB (1999) Reprogramming of intestinal differentiation and intercalary regeneration in Cdx2 mutant mice. Proc Natl Acad Sci U S A 96:7318–7323

Borchard F, Ghanei A, Koldovsky U, Hengels KJ, Bückmann FW (1990) Gastrale Differenzierung in Adenomen der Magenschleimhaut. Immunhistochemische und elektronenmikroskopische Untersuchungen. Verh Dtsch Ges Pathol 74:523

Borchard F, Bodensieck U, Koldovsky U (1993) Entwicklung des monoklonalen Antikörpers R3C4 gegen das foveoläre Muzin M1. Verh Dtsch Ges Pathol 74:523

Devereaux CE, Devereaux RG (1994) Heterotopic gastric mucosa of the rectum with a review of the literature. J Clin Gastroenterol 19:41–45

Elster K (1976) In: Morson BC (ed) Current topics in pathology 63. Springer, Berlin Heidelberg New York, p 86

Fenoglio–Preisser CM (1999) Gastrointestinal pathology. Lippincott–Raven, Philadelphia

10.

Hanisch FG, Koldovsky U, Borchard F (1993) Monoclonal antibody 2B5 defines a truncated O-glycan, GlcNAc beta 1–3Gal beta 1–4GlcNAc beta 1–6 (GalNAc), on mucins from deep gastric and duodenal glands as well as metaplasia and neoplasia of gastric differentiation. Cancer Res 53:4791–4796

11.

Mukaisho K, Miwa K, Kumagai H, Bamba M, Sugihara H, Hattori T (2003) Gastric carcinogenesis by duodenal reflux through gut regenerative cell lineage. Dig Dis Sci 48:2153–2158

12.

Kato N, Akiyama S, Motoyama T (2002) Pyloric gland-type tubular adenoma superimposed on intraductal papillary mucinous tumor of the pancreas. Pyloric gland adenoma of the pancreas. Virchows Arch 440:205–208

13.

Kato Y, Sugano H, Rubio CA (1983) Classification of intramucosal cysts of the stomach. Histopathology 7:931–938

14.

Kestemberg A, Marino G, de Lima E, Garcia FT, Carrascal E, Arredondo JL (1993) Gastric heterotopic mucosa in the rectum with Helicobacter pylori-like organisms: a rare cause of rectal bleeding. Int J Colorectal Dis 8:9–12

15.

Kushima R, Remmele W, Stolte M, Borchard F (1996) Pyloric gland type adenoma of the gallbladder with squamoid spindle cell metaplasia. Pathol Res Pract 192:963–969

16.

Kushima R, Ruthlein HJ, Stolte M, Bamba M, Hattori T, Borchard F (1999) “Pyloric gland-type adenoma” arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type. Virchows Arch 435:452–457

17.

Laitio M (1975) Goblet cells, enterochromaffin cells, superficial gastric-type epithelium and antral-type glands in the gallbladder. Beitr Pathol 156:343–358

18.

Levine DS (1987) “Solitary” rectal ulcer syndrome. Are “solitary” rectal ulcer syndrome and “localized” colitis cystica profunda analogous syndromes caused by rectal prolapse? Gastroenterology 92:243–253

19.

Lewin KJ, Riddell RH, Weinstein WM (1992) Gastrointestinal pathology and its clinical implications. Igaku–Shoin, New York

20.

Lohe B, Ghanei A, Koldovsky U, Borchard F (1990) Gastrale Differenzierung in Neoplasien der Gallenblase–Untersuchungen mit dem monoklonalen Antikörper 2B5. Verh Dtsch Ges Pathol 74:529

21.

Mizoshita T, Inada K, Tsukamoto T, Kodera Y, Yamamura Y, Hirai T, Kato T, Joh T, Itoh M, Tatematsu M (2001) Expression of Cdx1 and Cdx2 mRNAs and relevance of this expression to differentiation in human gastrointestinal mucosa-with special emphasis on participation in intestinal metaplasia of the human stomach. Gastric Cancer 4:185–191

22.

Murray FE, Lombard M, Dervan P, Fitzgerald RJ, Crowe J (1988) Bleeding from multifocal heterotopic gastric mucosa in the colon controlled by an H₂ antagonist. Gut 29:848–851

23.

Seitz G, Schuder G (1987) Heterotopic gastric mucosa of the rectum. Pathologe 8:52–55

24.

Stolte M, Sticht T, Eidt S, Ebert D, Finkenzeller G (1994) Frequency, location, and age and sex distribution of various types of gastric polyp. Endoscopy 26:659–665

25.

Stolte M (1995) Clinical consequences of the endoscopic diagnosis of gastric polyps. Endoscopy 27:32–37

26.

Vieth M, Kushima R, Borchard F, Stolte M (2003) Pyloric gland adenoma: a clinico-pathological analysis of 90 cases. Virchows Arch 442:317–321

27.

Watanabe H, Jass JR, Sobin LH (eds) (1990) Histological typing of oesophageal and gastric tumours. Springer, Berlin Heidelberg New York

28.

Wolff M (1971) Heterotopic gastric epithelium in the rectum: a report of three new cases with a review of 87 cases of gastric heterotopia in the alimentary canal. Am J Clin Pathol 55:604–616

Title: Adenoma with gastric differentiation (so-called pyloric gland adenoma) in a heterotopic gastric corpus mucosa in the rectum
Authors: M. Vieth
R. Kushima
J. P. A. de Jonge
F. Borchard
F. Oellig
M. Stolte
Publication date: 01-05-2005
Publisher: Springer-Verlag
Published in: Virchows Archiv / Issue 5/2005
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-005-1242-2

2024 ASCO Annual Meeting

Springer Medicine

Adenoma with gastric differentiation (so-called pyloric gland adenoma) in a heterotopic gastric corpus mucosa in the rectum

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2005

An overview of the Sino–German symposium on new developments in surgical and basic pathology

Stromal remodeling and SPARC (secreted protein acid rich in cysteine) expression in invasive ductal carcinomas of the breast

Hepatic adenocarcinoma expressing inhibin in a young patient on oral contraceptives

Pyloric gland adenoma arising in Barrett’s esophagus with mucin immunohistochemical and molecular cytogenetic evaluation

Congenital “clear cell sarcoma of the kidney”

Heme oxygenase-1 accelerates protumoral effects of nitric oxide in cancer cells