Abstract
Background and Aims: We aimed to investigate an association between clinicopathological features, including immunohistochemical mucin phenotypes, and magnifying chromoendoscopic findings with crystal violet staining (ME-CV) in non-ampullary duodenal epithelial tumors (NADETs). Methods: A total of 55 patients with NADET were divided into 3 groups by mucin phenotype: intestinal, gastrointestinal, or gastric. ME-CV findings were classified into 4 patterns: convoluted, leaf-like, reticular/sulciolar, and pinecone. The clinicopathological features and ME-CV findings were compared among the mucin phenotypes. Results: Tumors of the gastric type were located in the duodenal bulb (p < 0.001), and contained pyloric gland adenoma (p < 0.001) more frequently than the other types. White-light endoscopy indicated that milk-white mucosa was less frequent in tumors of the gastric type than in those of the gastrointestinal type (p = 0.006) and the intestinal type (p < 0.001). ME-CV findings were significantly different between the gastric type and the other type (p = 0.028). Totally, 5 of 8 tumors of the gastric type manifested a pinecone pattern, 4 of which were compatible with pyloric gland adenoma. Conclusions: The endoscopic findings of NADETs differ according to mucin phenotype. A pinecone pattern under ME-CV may be characteristic of NADETs of the gastric type, especially pyloric gland adenoma.
Journal Section:
Original Paper
References
1.
Endo M, Abiko Y, Oana S, et al: Usefulness of endoscopic treatment for duodenal adenoma. Dig Endosc 2010; 22: 360–365.
[PubMed]
2.
Jepsen JM, Persson M, Jakobsen NO, et al: Prospective study of prevalence and endoscopic and histopathologic characteristics of duodenal polyps in patients submitted to upper endoscopy. Scand J Gastroenterol 1994; 29: 483–487.
[PubMed]
3.
Goda K, Kikuchi D, Yamamoto Y, et al: Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors in Japan: multicenter case series. Dig Endosc 2014; 26(suppl 2):23–29.
[PubMed]
4.
Inoue T, Uedo N, Yamashina T, et al: Delayed perforation: a hazardous complication of endoscopic resection for non-ampullary duodenal neoplasm. Dig Endosc 2014; 26: 220–227.
[PubMed]
5.
Kakushima N, Kanemoto H, Tanaka M, et al: Treatment for superficial non-ampullary duodenal epithelial tumors. World J Gastroenterol 2014; 20: 12501–12508.
[PubMed]
6.
Nonaka S, Oda I, Tada K, et al: Clinical outcome of endoscopic resection for nonampullary duodenal tumors. Endoscopy 2015; 47: 129–135.
[PubMed]
7.
Hoteya S, Furuhata T, Takahito T, et al: Endoscopic submucosal dissection and endoscopic mucosal resection for non-ampullary superficial duodenal tumor. Digestion 2017; 95: 36–42.
[PubMed]
8.
Kinoshita S, Nishizawa T, Ochiai Y, et al: Accuracy of biopsy for the preoperative diagnosis of superficial nonampullary duodenal adenocarcinoma. Gastrointest Endosc 2017; 86: 329–332.
[PubMed]
9.
Kakushima N, Ono H, Takao T, et al: Method and timing of resection of superficial non-ampullary duodenal epithelial tumors. Dig Endosc 2014; 26(suppl 2):35–40.
[PubMed]
10.
Kikuchi D, Hoteya S, Iizuka T, et al: Diagnostic algorithm of magnifying endoscopy with narrow band imaging for superficial non-ampullary duodenal epithelial tumors. Dig Endosc 2014; 26(suppl 2):16–22.
[PubMed]
11.
Tsuji S, Doyama H, Tsuji K, et al: Preoperative endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors, including magnifying endoscopy. World J Gastroenterol 2015; 21: 11832–11841.
[PubMed]
12.
Mizumoto T, Sanomura Y, Tanaka S, et al: Clinical usefulness of magnifying endoscopy for non-ampullary duodenal tumors. Endosc Int Open 2017; 5:E297–E302.
[PubMed]
13.
Endo M, Matsumoto T, Sugai T: Diagnosis and treatment of duodenal tumors (in Japanese with an English abstract). Gastroenterol Endosc 2014; 56: 3763–3774.
14.
Toba T, Inoshita N, Kaise M, et al: Clinicopathological features of superficial non-ampurally duodenal epithelial tumor; gastric phenotype of histology correlates to higher malignant potency. J Gastroenterol 2017, Epub ahead of print.
[PubMed]
15.
Mitsuishi T, Hamatani S, Hirooka S, et al: Clinicopathological characteristics of duodenal epithelial neoplasms: focus on tumors with a gastric mucin phenotype (pyloric gland-type tumors). PLos One 2017; 12: e0174985.
[PubMed]
16.
Ushiku T, Arnason T, Fukayama M, et al: Extra-ampullary duodenal adenocarcinoma. Am J Surg Pathol 2014; 38: 1484–1493.
[PubMed]
17.
Yoshimura N, Goda K, Tajiri H, et al: Endoscopic features of nonampullary duodenal tumors with narrow-band imaging. Hepatogastroenterology 2010; 57: 462–467.
[PubMed]
18.
Dixon MF: Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 2002; 51: 130–131.
[PubMed]
19.
Bosman FT, Carneiro F, Hruban RH, et al: WHO Classification of Tumors Pathology and Genetics Tumors of the Digestive System. Lyon, IARC, 2010.
20.
Watanabe H, Jass JR, Sobin LH: Histological Typing of Oesophageal and Gastric Tumors. Berlin, Springer,1990.
21.
Kobayashi M, Takeuchi M, Ajioka Y, et al: Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer. J Gastroenterol 2011; 46: 1064–1070.
[PubMed]
22.
Fujii T, Hasegawa RT, Saitoh Y et al: Chromoscopy during colonoscopy. Endoscopy 2001; 33: 1036–1041.
[PubMed]
23.
Ueo T, Yonemasu H, Yao K, et al: Histologic differentiation and mucin phenotype in white opaque substance-positive gastric neoplasias. Endosc Int Open 2015; 3:E597–E604.
[PubMed]
24.
Vieth M, Kushima R, Borchard F, et al: Pyloric gland adenoma: a clinico-pathological analysis of 90 cases. Virchows Arch 2003; 442: 317–331.
[PubMed]
25.
Chen ZM, Scudiere JR, Abraham SC, et al: Pyloric gland adenoma: an entity distinct from gastric foveolar type adenoma. Am J Surg Pathol 2009; 33: 186–193.
[PubMed]
26.
Matsubara A, Sekine S, Kushima R, et al: Frequent GNAS and KRAS mutations in pyloric gland adenoma of the stomach and duodenum. J Pathol 2013; 229: 579–587.
[PubMed]
© 2018 S. Karger AG, Basel
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