Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA.
Histopathology. 2022 Jan;80(2):348-359. doi: 10.1111/his.14553. Epub 2021 Oct 7.
Adenomatoid tumours are mesothelial-derived benign neoplasms with a predilection for the genital tract. Extragenital sites are rare and can cause significant diagnostic challenges. Herein, we describe the clinicopathological features of a cohort of adenomatoid tumours involving the gastrointestinal tract and liver in order to more clearly characterise their histological findings and aid in diagnosis.
The pathology databases at four institutions were searched for adenomatoid tumours involving the gastrointestinal tract or liver, yielding eight cases. Available clinicoradiological and follow-up data were collected from the medical records. Six tumours were incidentally discovered during imaging studies or at the time of surgical exploration for unrelated conditions; presenting symptoms were unknown in two patients. Histologically, the tumours were well-circumscribed, although focal ill-defined borders were present in four cases. No infiltration of adjacent structures was identified. Architectural heterogeneity was noted in five (63%) tumours; an adenoid pattern often predominated. The neoplastic cells were flattened to cuboidal with eosinophilic cytoplasm. Cytoplasmic vacuoles mimicking signet ring-like cells were present in five (63%) cases. Three (38%) cases showed involvement of the mesothelium with reactive mesothelial hyperplasia. Cytological atypia or increased mitotic activity was not identified. The surrounding stroma ranged from oedematous/myxoid to densely hyalinised. Immunohistochemistry confirmed mesothelial origin in all cases evaluated. No patients developed recurrence of disease.
The current study evaluates the clinicopathological findings in a collective series of gastrointestinal and hepatic adenomatoid tumours, correlating with those described in individually reported cases. We highlight common histological features and emphasise variable findings that could mimic a malignant neoplasm.
腺瘤样肿瘤是间皮来源的良性肿瘤，倾向于发生在生殖道。生殖系统外部位罕见，可引起显著的诊断挑战。在此，我们描述了一组涉及胃肠道和肝脏的腺瘤样肿瘤的临床病理特征，以便更清楚地描述其组织学发现并有助于诊断。
在四个机构的病理学数据库中搜索涉及胃肠道或肝脏的腺瘤样肿瘤，共发现 8 例病例。从病历中收集了可获得的临床放射影像学和随访数据。6 例肿瘤是在影像学研究或因无关疾病进行手术探查时偶然发现的；两名患者的症状未知。组织学上，肿瘤边界清楚，但 4 例边界模糊。未发现邻近结构浸润。五例（63%）肿瘤存在结构异质性；常以腺样模式为主。肿瘤细胞呈扁平至立方状，胞质嗜酸性。五例（63%）肿瘤存在模拟印戒样细胞的细胞质空泡。三例（38%）肿瘤伴有间皮受累和反应性间皮增生。未发现细胞学异型性或核分裂活性增加。周围基质从水肿/黏液样到致密玻璃样变不等。免疫组织化学在所有评估的病例中均证实了间皮来源。没有患者出现疾病复发。
本研究评估了一组胃肠道和肝腺瘤样肿瘤的临床病理发现，并与单独报道的病例进行了比较。我们强调了常见的组织学特征和可变的表现，这些表现可能模仿恶性肿瘤。
