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病例报告:两例位于不同部位的伴有高级别上皮内瘤变的幽门腺瘤。

Case report: Two cases of pyloric adenomas with high-grade intraepithelial neoplasia at distinct locations.

作者信息

Li Yuetian, Chen Shuai, Zhao Xuechun, Wang Quanyi

机构信息

Clinical School of Medicine, Jining Medical University, Jining, Shandong, China.

Department of Pathology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.

出版信息

Front Immunol. 2024 Dec 13;15:1485840. doi: 10.3389/fimmu.2024.1485840. eCollection 2024.

Abstract

The rare gastrointestinal tract epithelial polyp known as a pyloric gland adenoma (PGA) is more common in elderly women and uncommon in the duodenum. There are reports of two PGA cases involving high-grade intraepithelial neoplasia. A 75-year-old man was admitted to the hospital as Patient 1 due to "epigastric distension and pain for more than 10 days". The mucous membrane around the stomach fundus and body was thin, and an electron gastroscopy revealed a large, thick protrusion in the stomach fundus that measured about 6 cm in circumference. High-grade intraepithelial neoplasia and stomach pyloric adenoma are the pathological diagnoses. An outside hospital provided consultation for Patient 2, a 68-year-old male. Pyloric adenoma at duodenal bulb with high-grade intraepithelial neoplasia is the pathological diagnosis. The single layer of cuboidal to low columnar epithelial cells with rounded nuclei and eosinophilic cytoplasm was surrounded by densely packed glands with sporadic cystic dilatation that made up the tumor tissue. The diagnosis of PGA required the immunohistochemical labeling of MUC6. In both cases, simple surgical resection was carried out, and followed up for half a year, no recurrence.

摘要

一种罕见的胃肠道上皮息肉,即幽门腺腺瘤(PGA),在老年女性中更为常见,在十二指肠中则不常见。有两例PGA病例报告涉及高级别上皮内瘤变。一名75岁男性因“上腹胀痛10余天”入院,作为患者1。胃底和胃体周围的黏膜变薄,电子胃镜检查发现胃底有一个大的、厚的突出物,周长约6厘米。病理诊断为高级别上皮内瘤变和胃幽门腺腺瘤。另一家医院为患者2(一名68岁男性)提供了会诊。病理诊断为十二指肠球部幽门腺腺瘤伴高级别上皮内瘤变。单层立方形至低柱状上皮细胞,核圆形,胞质嗜酸性,周围是密集排列的腺体,伴有散在的囊性扩张,构成肿瘤组织。PGA的诊断需要进行MUC6免疫组化标记。在这两例病例中,均进行了单纯手术切除,并随访半年,无复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4826/11671352/3c42a1024dd6/fimmu-15-1485840-g001.jpg

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