Difference between revisions of "Pyloric gland adenoma"

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'''Pyloric gland adenoma''' is an uncommon [[gastrointestinal pathology|gastrointestinal]] lesion.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| Synonyms  =
| Micro      = foveolar-type glands with eosinophilic (or clear) cytoplasm, nuclei with or without dysplasia
| Subtypes  =
| LMDDx      = foveolar-type [[gastric adenoma]], well-differentiated [[gastric adenocarcinoma]]
| Stains    =
| IHC        = MUC6 +ve, MUC5AC +ve, Ki-67 high
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[stomach]], [[duodenum]], [[gallbladder]], others
| Assdx      = well-differentiated [[gastric adenocarcinoma]], [[autoimmune gastritis]]
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  = polyp
| Prognosis  = benign
| Other      =
| ClinDDx    = other [[GI polyps|polyps]]
| Tx        = excision
}}
'''Pyloric gland adenoma''', abbreviated '''PGA''', is an uncommon [[gastrointestinal pathology|gastrointestinal]] lesion.


==General==
==General==
*Less than 3% of gastric polyps.<ref>{{Cite journal  | last1 = Vieth | first1 = M. | last2 = Vogel | first2 = C. | last3 = Kushima | first3 = R. | last4 = Borchard | first4 = F. | last5 = Stolte | first5 = M. | title = Pyloric gland adenoma-- how to diagnose? | journal = Cesk Patol | volume = 42 | issue = 1 | pages = 4-7 | month = Jan | year = 2006 | doi =  | PMID = 16506593 }}</ref>
*Approximately 3% of gastric polyps.<ref name=pmid16506593>{{Cite journal  | last1 = Vieth | first1 = M. | last2 = Vogel | first2 = C. | last3 = Kushima | first3 = R. | last4 = Borchard | first4 = F. | last5 = Stolte | first5 = M. | title = Pyloric gland adenoma-- how to diagnose? | journal = Cesk Patol | volume = 42 | issue = 1 | pages = 4-7 | month = Jan | year = 2006 | doi =  | PMID = 16506593 }}</ref>
*Associated with [[autoimmune gastritis]].<ref>{{Cite journal  | last1 = Vieth | first1 = M. | last2 = Montgomery | first2 = EA. | title = Some observations on pyloric gland adenoma: an uncommon and long ignored entity! | journal = J Clin Pathol | volume =  | issue =  | pages =  | month = Aug | year = 2014 | doi = 10.1136/jclinpath-2014-202553 | PMID = 25092673 }}</ref>
*Associated with [[autoimmune gastritis]].<ref>{{Cite journal  | last1 = Vieth | first1 = M. | last2 = Montgomery | first2 = EA. | title = Some observations on pyloric gland adenoma: an uncommon and long ignored entity! | journal = J Clin Pathol | volume =  | issue =  | pages =  | month = Aug | year = 2014 | doi = 10.1136/jclinpath-2014-202553 | PMID = 25092673 }}</ref>
*More often seen in women as with autoimmune gastritis.
*Associated with [[gastric adenocarcinoma]].


==Microscopic==
==Microscopic==
Features:<ref name=pmid18830123/>
*Round mildly irregular foveolar-type glands with:
**Nuclei without dysplasia (round and basally located nuclei) or with dysplasia.
**Moderate eosinophilic (or clear) cytoplasm. 


DDx:
DDx:
*[[Gastric adenoma]].
*[[Gastric adenoma]], foveolar-type.
*[[Adenocarcinoma of the stomach]].
*[[Adenocarcinoma of the stomach]], well-differentiated.
 
===Images===
*[http://www.flickriver.com/photos/lunarcaustic/3488308419/ Tubulare adenoma, pyloric gland-type (flickriver.com)].


==IHC==
==IHC==
*Ki-67 high.
*Ki-67 high.
*MUC6 +ve.{{fact}}
*MUC6 +ve.<ref name=pmid18830123>{{Cite journal  | last1 = Chen | first1 = ZM. | last2 = Scudiere | first2 = JR. | last3 = Abraham | first3 = SC. | last4 = Montgomery | first4 = E. | title = Pyloric gland adenoma: an entity distinct from gastric foveolar type adenoma. | journal = Am J Surg Pathol | volume = 33 | issue = 2 | pages = 186-93 | month = Feb | year = 2009 | doi = 10.1097/PAS.0b013e31817d7ff4 | PMID = 18830123 }}</ref>
**Negative in foveolar-type gastric adenomas.
*MUC5AC +ve.<ref name=pmid18830123/>
 
==See also==
*[[Autoimmune gastritis]].


==References==
==References==
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[[Category:Gastrointestinal pathology]]
[[Category:Gastrointestinal pathology]]
[[Category:Diagnosis]]

Latest revision as of 17:53, 15 September 2022

Pyloric gland adenoma
Diagnosis in short

LM foveolar-type glands with eosinophilic (or clear) cytoplasm, nuclei with or without dysplasia
LM DDx foveolar-type gastric adenoma, well-differentiated gastric adenocarcinoma
IHC MUC6 +ve, MUC5AC +ve, Ki-67 high
Site stomach, duodenum, gallbladder, others

Associated Dx well-differentiated gastric adenocarcinoma, autoimmune gastritis
Prevalence uncommon
Endoscopy polyp
Prognosis benign
Clin. DDx other polyps
Treatment excision

Pyloric gland adenoma, abbreviated PGA, is an uncommon gastrointestinal lesion.

General

Microscopic

Features:[3]

  • Round mildly irregular foveolar-type glands with:
    • Nuclei without dysplasia (round and basally located nuclei) or with dysplasia.
    • Moderate eosinophilic (or clear) cytoplasm.

DDx:

Images

IHC

  • Ki-67 high.
  • MUC6 +ve.[3]
    • Negative in foveolar-type gastric adenomas.
  • MUC5AC +ve.[3]

See also

References

  1. Vieth, M.; Vogel, C.; Kushima, R.; Borchard, F.; Stolte, M. (Jan 2006). "Pyloric gland adenoma-- how to diagnose?". Cesk Patol 42 (1): 4-7. PMID 16506593.
  2. Vieth, M.; Montgomery, EA. (Aug 2014). "Some observations on pyloric gland adenoma: an uncommon and long ignored entity!". J Clin Pathol. doi:10.1136/jclinpath-2014-202553. PMID 25092673.
  3. 3.0 3.1 3.2 Chen, ZM.; Scudiere, JR.; Abraham, SC.; Montgomery, E. (Feb 2009). "Pyloric gland adenoma: an entity distinct from gastric foveolar type adenoma.". Am J Surg Pathol 33 (2): 186-93. doi:10.1097/PAS.0b013e31817d7ff4. PMID 18830123.