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Clinicopathological features of pyloric gland adenomas of the duodenum: a multicentre study of 57 cases.

Authors :
Miller GC
Kumarasinghe MP
Borowsky J
Choi WT
Setia N
Clauditz T
Gidwani R
Sufiyan W
Lauwers GY
Brown IS
Source :
Histopathology [Histopathology] 2020 Feb; Vol. 76 (3), pp. 404-410. Date of Electronic Publication: 2019 Dec 01.
Publication Year :
2020

Abstract

Aims: To determine the clinicopathological features of pyloric gland adenomas (PGA) that arise in the duodenum.<br />Methods and Results: Fifty-seven cases of duodenal PGA were identified and analysed from 56 patients. Clinicopathological and immunohistochemical analyses were performed. PGA tend to occur in older individuals (median age = 73.5), with a slight female predominance (25 males, 31 females). PGA arise more commonly in the proximal duodenum (68.75% in D1, 25% in D2 and 6.25% in D3) and usually present as mucosal nodules (98.2%) or plaques (1.8%), with a mean size of 14.8 mm. There is associated gastric heterotopia in 22.8% of cases. PGA showing features of high-grade dysplasia were significantly larger in size than PGA, showing only low-grade dysplasia (23.1 versus 8.7 mm; P = 0.0001) and more likely to show a tubulovillous rather than a pure tubular architecture (P = 0.025). In our series, 10 of 56 patients had intramucosal or invasive carcinoma associated with the duodenal PGA (17.9%). Three of these carcinomas showed lymph node metastasis. Following definitive treatment, local recurrence occurred in only three patients.<br />Conclusions: Duodenal PGA tend to occur in the proximal duodenum of older individuals. Larger size and tubulovillous architecture correlates with high-grade dysplasia and associated adenocarcinoma. The low recurrence rate of these lesions would suggest that endoscopic management is appropriate, provided that the lesion can be completely resected.<br /> (© 2019 John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1365-2559
Volume :
76
Issue :
3
Database :
MEDLINE
Journal :
Histopathology
Publication Type :
Academic Journal
Accession number :
31529725
Full Text :
https://doi.org/10.1111/his.13996