Chief cell hyperplasia with structural and nuclear atypia

A variant of fundic gland polyp

Akihiro Matsukawa, Ryoichi Kurano, Takahiro Takemoto, Motoko Kagayama, Takaaki Ito

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

A case of an unusual variant of fundic gland polyp (FGP) composed of chief cell hyperplasia with structural and nuclear atypia in an 87-year-old woman is presented. Gastrointestinal endoscopy revealed a sessile polyp in the cardia/corpus transition zone and a polypoid lesion in the fundus. Histologically, the polyp in the cardia/corpus showed a typical appearance of FGP, while that in fundus demonstrated a tumorous lesion composed of irregular branched tubules with nuclear stratification. Despite the structural distortion and nuclear atypia, mitotic figures were absent and MIB-1 positive cells were less than 3%. Immunohistochemically, the cytoplasms of the tubules were negative for gastric mucin and Muc-5AC glycoprotein, but mostly positive for pepsinogen-I, indicating that the proliferated glands consisted mainly of chief cells, not mucous cells. Parietal cells were occasionally found in the glands. At the periphery of the lesion, microcysts composed of parietal cells, chief cells, and mucous cells had developed. Altogether, the polyp in the fundus was diagnosed as an unusual variant of FGP with chief cell hyperplasia. This FGP should be differentiated from tubular adenocarcinoma. Proliferation of chief cells with occasional parietal cells is critical for the differential diagnosis.

Original languageEnglish
Pages (from-to)817-821
Number of pages5
JournalPathology Research and Practice
Volume200
Issue number11-12
DOIs
Publication statusPublished - Feb 22 2005
Externally publishedYes

Fingerprint

Polyps
Hyperplasia
Cardia
Mucin 5AC
Gastric Mucins
Pepsinogen A
Gastrointestinal Endoscopy
Glycoproteins
Cytoplasm
Adenocarcinoma
Differential Diagnosis
Cell Proliferation

Keywords

  • Fundic gland polyp
  • Gastric cancer
  • Structural atypia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Chief cell hyperplasia with structural and nuclear atypia : A variant of fundic gland polyp. / Matsukawa, Akihiro; Kurano, Ryoichi; Takemoto, Takahiro; Kagayama, Motoko; Ito, Takaaki.

In: Pathology Research and Practice, Vol. 200, No. 11-12, 22.02.2005, p. 817-821.

Research output: Contribution to journalArticle

Matsukawa, Akihiro ; Kurano, Ryoichi ; Takemoto, Takahiro ; Kagayama, Motoko ; Ito, Takaaki. / Chief cell hyperplasia with structural and nuclear atypia : A variant of fundic gland polyp. In: Pathology Research and Practice. 2005 ; Vol. 200, No. 11-12. pp. 817-821.
@article{a958f43e6f9a44fc8b4fda5a76433008,
title = "Chief cell hyperplasia with structural and nuclear atypia: A variant of fundic gland polyp",
abstract = "A case of an unusual variant of fundic gland polyp (FGP) composed of chief cell hyperplasia with structural and nuclear atypia in an 87-year-old woman is presented. Gastrointestinal endoscopy revealed a sessile polyp in the cardia/corpus transition zone and a polypoid lesion in the fundus. Histologically, the polyp in the cardia/corpus showed a typical appearance of FGP, while that in fundus demonstrated a tumorous lesion composed of irregular branched tubules with nuclear stratification. Despite the structural distortion and nuclear atypia, mitotic figures were absent and MIB-1 positive cells were less than 3{\%}. Immunohistochemically, the cytoplasms of the tubules were negative for gastric mucin and Muc-5AC glycoprotein, but mostly positive for pepsinogen-I, indicating that the proliferated glands consisted mainly of chief cells, not mucous cells. Parietal cells were occasionally found in the glands. At the periphery of the lesion, microcysts composed of parietal cells, chief cells, and mucous cells had developed. Altogether, the polyp in the fundus was diagnosed as an unusual variant of FGP with chief cell hyperplasia. This FGP should be differentiated from tubular adenocarcinoma. Proliferation of chief cells with occasional parietal cells is critical for the differential diagnosis.",
keywords = "Fundic gland polyp, Gastric cancer, Structural atypia",
author = "Akihiro Matsukawa and Ryoichi Kurano and Takahiro Takemoto and Motoko Kagayama and Takaaki Ito",
year = "2005",
month = "2",
day = "22",
doi = "10.1016/j.prp.2004.10.005",
language = "English",
volume = "200",
pages = "817--821",
journal = "Pathology Research and Practice",
issn = "0344-0338",
publisher = "Urban und Fischer Verlag GmbH und Co. KG",
number = "11-12",

}

TY - JOUR

T1 - Chief cell hyperplasia with structural and nuclear atypia

T2 - A variant of fundic gland polyp

AU - Matsukawa, Akihiro

AU - Kurano, Ryoichi

AU - Takemoto, Takahiro

AU - Kagayama, Motoko

AU - Ito, Takaaki

PY - 2005/2/22

Y1 - 2005/2/22

N2 - A case of an unusual variant of fundic gland polyp (FGP) composed of chief cell hyperplasia with structural and nuclear atypia in an 87-year-old woman is presented. Gastrointestinal endoscopy revealed a sessile polyp in the cardia/corpus transition zone and a polypoid lesion in the fundus. Histologically, the polyp in the cardia/corpus showed a typical appearance of FGP, while that in fundus demonstrated a tumorous lesion composed of irregular branched tubules with nuclear stratification. Despite the structural distortion and nuclear atypia, mitotic figures were absent and MIB-1 positive cells were less than 3%. Immunohistochemically, the cytoplasms of the tubules were negative for gastric mucin and Muc-5AC glycoprotein, but mostly positive for pepsinogen-I, indicating that the proliferated glands consisted mainly of chief cells, not mucous cells. Parietal cells were occasionally found in the glands. At the periphery of the lesion, microcysts composed of parietal cells, chief cells, and mucous cells had developed. Altogether, the polyp in the fundus was diagnosed as an unusual variant of FGP with chief cell hyperplasia. This FGP should be differentiated from tubular adenocarcinoma. Proliferation of chief cells with occasional parietal cells is critical for the differential diagnosis.

AB - A case of an unusual variant of fundic gland polyp (FGP) composed of chief cell hyperplasia with structural and nuclear atypia in an 87-year-old woman is presented. Gastrointestinal endoscopy revealed a sessile polyp in the cardia/corpus transition zone and a polypoid lesion in the fundus. Histologically, the polyp in the cardia/corpus showed a typical appearance of FGP, while that in fundus demonstrated a tumorous lesion composed of irregular branched tubules with nuclear stratification. Despite the structural distortion and nuclear atypia, mitotic figures were absent and MIB-1 positive cells were less than 3%. Immunohistochemically, the cytoplasms of the tubules were negative for gastric mucin and Muc-5AC glycoprotein, but mostly positive for pepsinogen-I, indicating that the proliferated glands consisted mainly of chief cells, not mucous cells. Parietal cells were occasionally found in the glands. At the periphery of the lesion, microcysts composed of parietal cells, chief cells, and mucous cells had developed. Altogether, the polyp in the fundus was diagnosed as an unusual variant of FGP with chief cell hyperplasia. This FGP should be differentiated from tubular adenocarcinoma. Proliferation of chief cells with occasional parietal cells is critical for the differential diagnosis.

KW - Fundic gland polyp

KW - Gastric cancer

KW - Structural atypia

UR - http://www.scopus.com/inward/record.url?scp=13544262631&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13544262631&partnerID=8YFLogxK

U2 - 10.1016/j.prp.2004.10.005

DO - 10.1016/j.prp.2004.10.005

M3 - Article

VL - 200

SP - 817

EP - 821

JO - Pathology Research and Practice

JF - Pathology Research and Practice

SN - 0344-0338

IS - 11-12

ER -