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A method for the simultaneous demonstration of lysozyme and mucins in 39 cases of gastric adenomas differentiated two intermediate cell types. The first was similar to a columnar cell comprising a single cell population which covered extensive areas of the adenomas. This cell type often showed supranuclear lysozyme reactivity and apical neutral mucins, sialomucins, and sulphomucins in variable amounts. The second cell type was found in 11 adenomas, located mainly in the fundal area. It seemed to be a transitional form between the goblet cell and the Paneth cell. This cell type was scattered among columnar cells, occasional Paneth-like cells, and small goblet cells. These two types of intermediate cells may be regarded as abnormally differentiated integral elements of gastric adenomas. They may be associated with the neck stem cells in the cytogenesis of gastric adenomas.

3 adenomas and 5 carcinomas of the ampulla of Vater are studied to evaluate their histogenesis and diagnostic significance of the antigen defined by the monoclonal antibody CA 19/9. In the adenomas, some dysplastic glands show a faint positivity for CA 19/9 antigen, whereas in the ampullomas this antigen is present in adenomatous residue and in well differentiated adenocarcinomatous areas. The present observations indicate that the endoscopical and macro-microscopical examinations are fundamental to evaluate the location of the ampullary neoplasia. Moreover, the immunohistochemical finding of the CA 19/9 antigen in adenomas and carcinomas suggests their histogenetic relationship, but it is not useful in their differential diagnosis.