Pyloric gland adenoma

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

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

General

Microscopic

Features:

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

DDx:

IHC

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

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 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.