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Does ampullary carcinoma arise from distended glands in the papilla of Vater?
J Hepatobiliary Pancreat Surg 2008; 15(2):161-8JH

Abstract

BACKGROUND/PURPOSE

Glands near the surface of the papilla of Vater may become distended with mucus and become hyperplastic; that is, become distended. In this study, we tried to clarify carcinogenesis in these distended glands.

METHODS

Twenty-nine pancreatoduodenectomized nontumorous duodenal papilla specimens from carcinoma of the pancreas and bile duct and 34 resected ampullary carcinoma specimens were studied histopathologically and immunohistochemically, using cytokeratins and mucin immunohistochemical features/phenotypes.

RESULTS

Distended glands were found in 11 of the 29 pancreatoduodenectomized specimens. These glands were immunopositive for cytokeratin (CK) 7 and MUC-5AC Glycoprotein (MUC5AC), but not for CK20, while the intrapapillary portion was CK7-positive and CK20-negative, but mostly negative for MUC5AC. Immunopositivity for CK7, CK20, and MUC5AC was found in 25, 21, and 18 of the 34 specimens of ampullary carcinoma, respectively. In 23 of the 34 specimens, immunoreactivity for MUC5AC and that for CK7 was coincident, that is, when the former was immunopositive, so was the latter, and vice versa, while in 25 of the 34 specimens, immunoreactivity for MUC5AC was opposite to that for CK20. Among the 23 cases in which immunoreactivity for MUC5AC and CK7 was coincident, 10 were MUC5AC+, CK7+, CK20- and 7 were MUC5AC-, CK7-, CK20+, suggestive of disease arising from the pancreaticobiliary mucosa or the distended glands in the former and disease arising from the duodenal mucosa in the latter. In MUC5AC+ cases, other than the 10 cases of MUC5AC+, CK7+, CK20-, 6 were double-positive and 1 was double-negative for CK7 and CK20, and 1 was CK20-positive, and at least 1 case showing double-negativity for CK7 and CK20 was suggestive of disease arising from the distended glands.

CONCLUSIONS

Although most ampullary carcinomas arise from the duodenal mucosa or intra-ampullary mucosa, both CK7-positive and MUC5AC-positive or only MUC5ACpositive ampullary carcinomas may arise from the distended glands.

Authors+Show Affiliations

Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18392709

Citation

Sonoue, Hiroshi, et al. "Does Ampullary Carcinoma Arise From Distended Glands in the Papilla of Vater?" Journal of Hepato-biliary-pancreatic Surgery, vol. 15, no. 2, 2008, pp. 161-8.
Sonoue H, Suda K, Nobukawa B, et al. Does ampullary carcinoma arise from distended glands in the papilla of Vater? J Hepatobiliary Pancreat Surg. 2008;15(2):161-8.
Sonoue, H., Suda, K., Nobukawa, B., Abe, H., Arakawa, A., Hirai, S., & Matsumoto, T. (2008). Does ampullary carcinoma arise from distended glands in the papilla of Vater? Journal of Hepato-biliary-pancreatic Surgery, 15(2), pp. 161-8. doi:10.1007/s00534-007-1228-3.
Sonoue H, et al. Does Ampullary Carcinoma Arise From Distended Glands in the Papilla of Vater. J Hepatobiliary Pancreat Surg. 2008;15(2):161-8. PubMed PMID: 18392709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does ampullary carcinoma arise from distended glands in the papilla of Vater? AU - Sonoue,Hiroshi, AU - Suda,Koichi, AU - Nobukawa,Bunsei, AU - Abe,Hiroshi, AU - Arakawa,Atsushi, AU - Hirai,Shu, AU - Matsumoto,Toshiharu, Y1 - 2008/04/06/ PY - 2007/01/29/received PY - 2007/03/17/accepted PY - 2008/4/9/pubmed PY - 2008/10/22/medline PY - 2008/4/9/entrez SP - 161 EP - 8 JF - Journal of hepato-biliary-pancreatic surgery JO - J Hepatobiliary Pancreat Surg VL - 15 IS - 2 N2 - BACKGROUND/PURPOSE: Glands near the surface of the papilla of Vater may become distended with mucus and become hyperplastic; that is, become distended. In this study, we tried to clarify carcinogenesis in these distended glands. METHODS: Twenty-nine pancreatoduodenectomized nontumorous duodenal papilla specimens from carcinoma of the pancreas and bile duct and 34 resected ampullary carcinoma specimens were studied histopathologically and immunohistochemically, using cytokeratins and mucin immunohistochemical features/phenotypes. RESULTS: Distended glands were found in 11 of the 29 pancreatoduodenectomized specimens. These glands were immunopositive for cytokeratin (CK) 7 and MUC-5AC Glycoprotein (MUC5AC), but not for CK20, while the intrapapillary portion was CK7-positive and CK20-negative, but mostly negative for MUC5AC. Immunopositivity for CK7, CK20, and MUC5AC was found in 25, 21, and 18 of the 34 specimens of ampullary carcinoma, respectively. In 23 of the 34 specimens, immunoreactivity for MUC5AC and that for CK7 was coincident, that is, when the former was immunopositive, so was the latter, and vice versa, while in 25 of the 34 specimens, immunoreactivity for MUC5AC was opposite to that for CK20. Among the 23 cases in which immunoreactivity for MUC5AC and CK7 was coincident, 10 were MUC5AC+, CK7+, CK20- and 7 were MUC5AC-, CK7-, CK20+, suggestive of disease arising from the pancreaticobiliary mucosa or the distended glands in the former and disease arising from the duodenal mucosa in the latter. In MUC5AC+ cases, other than the 10 cases of MUC5AC+, CK7+, CK20-, 6 were double-positive and 1 was double-negative for CK7 and CK20, and 1 was CK20-positive, and at least 1 case showing double-negativity for CK7 and CK20 was suggestive of disease arising from the distended glands. CONCLUSIONS: Although most ampullary carcinomas arise from the duodenal mucosa or intra-ampullary mucosa, both CK7-positive and MUC5AC-positive or only MUC5ACpositive ampullary carcinomas may arise from the distended glands. SN - 0944-1166 UR - https://www.unboundmedicine.com/medline/citation/18392709/Does_ampullary_carcinoma_arise_from_distended_glands_in_the_papilla_of_Vater L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0944-1166&date=2008&volume=15&issue=2&spage=161 DB - PRIME DP - Unbound Medicine ER -