Benign glandular downgrowth in gastric neuroendocrine neoplasms: a potential mimic of composite tumour. Issue 6 (30th October 2014)

• Record Type: Journal Article
• Authors: Ramineni, Maheshwari; Taggart, Melissa W; Rashid, Asif; Abraham, Susan C
• Is Part Of: Histopathology. Volume 65:Issue 6(2014)
• Page Start: 897
• Page End: 907
• Publication Date: 2014-10-30
• Subjects: Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12492
• Languages: English
• ISSNs: 0309-0167

Abstract

<abstract abstract-type="main" id="his12492-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="his12492-sec-0001" sec-type="section"> <title>Aims</title> <p>We have observed glandular downgrowth in some gastric neuroendocrine tumours (NETs), in which nonneoplastic appearing gastric glands are admixed with submucosal neuroendocrine nests, that could potentially be confused with composite tumours.</p> </sec> <sec id="his12492-sec-0002" sec-type="section"> <title>Methods and results</title> <p>We reviewed 68 gastric NETs with at least submucosal invasion, and evaluated associations between glandular downgrowth, clinical parameters (age, gender, NET setting) and tumour characteristics (size, depth of invasion, grade). Controls included 45 duodenal NETs. Glandular downgrowth was present in 28 (41%) gastric NETs but only 2 (4.4%) duodenal NETs (<italic>P </italic><<italic> </italic>0.0001). It was not related to age, gender, hypergastrinemia (downgrowth present in 43% of NETs arising in autoimmune gastritis, 41% of Zollinger–Ellison syndrome, 36% of sporadic NETs), tumour size, depth of invasion, or grade. Glandular downgrowth was confined to the submucosa even though 12 (18%) gastric NETs invaded muscularis propria. Submucosal gastric glands (pyloric type in 79%, intestinal in 50%, fundic in 29%) showed metaplastic changes similar to overlying mucosa, were usually mitotically inactive (64% of cases lacked mitotic figures), were geographically restricted to the NET, and never metastasized.</p> </sec> <sec id="his12492-sec-0003" sec-type="section"> <title>Conclusions</title> <p>Our findings support the frequent occurrence and nonneoplastic nature of glandular downgrowth in gastric NETs, which should not be mistaken for composite tumours.</p> </sec> </abstract>