The foamy variant of pancreatic intraepithelial neoplasia
The foamy variant of pancreatic intraepithelial neoplasia
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DOI：
10.1016/j.anndiagpath.2007.10.002
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发表时间：
2008-08-01
影响因子：
2
通讯作者：
Henson, Donald Earl
中科院分区：
文献类型：
--
作者：
Albores-Saavedra, Jorge;Weimersheimer-Sandoval, Mariana;Henson, Donald Earl
泡沫腺腺癌是胰腺导管癌的一种变种，其前体尚未被描述。我们在此描述与浸润性泡沫胰腺癌相关的胰腺上皮内瘤变(Panin)病变的形态和免疫组织化学特征。比较3例泡沫Panin病变和7例胰腺泡沫腺腺癌的染色、形态和免疫组织化学特征。苏木精伊红染色、迈尔粘液染色、高碘酸席夫染色和阿尔辛蓝染色均可用于所有病例的复查。免疫组织化学标记细胞角蛋白(CK)7、CK20、癌胚抗原多克隆、MUC1、MUC2、CDX2、P53和细胞周期蛋白D1。Panin-1病变位于非肿瘤性胰腺，与普通胰腺导管癌的Panin-1病变相似。Panin-2和Panin-3病变可立即在浸润性泡沫腺癌附近或内部识别。在这些病变中，小的或明显扩张的导管由立方和柱状发育不良的非泡沫细胞和泡沫细胞排列。2例可见鞋甲细胞。Panin-1、2、3病变和浸润性泡沫腺腺癌分别用粘液胺、高碘酸席夫和阿尔新蓝染色。CK7、癌胚抗原多克隆和MUC1标记的3例Panin-2和-3皮损和7例浸润性泡沫腺癌均呈阳性表达，而仅2例Panin-2和-3皮损和5例浸润性腺癌呈Cyclin D1和P53免疫反应阳性。在7例浸润性泡沫腺样胰腺癌中发现了3个不同的泡沫Panin病变。从Panin-1到Panin-3，Panin病变的细胞学和结构异常逐渐发展，排除了肿瘤导管扩散。这些起泡的Panin皮损可能是癌症的先兆。(C)2008 Elsevier Inc.保留所有权利。
Foamy gland adenocarcinoma is a variant of pancreatic ductal carcinoma, whose precursor has not been described. We describe here the morphologic and immunohistochemical features of the pancreatic intraepithelial neoplasia (PanIN) lesions associated with invasive foamy pancreatic adenocarcinoma. The staining properties and morphologic and immunohistochemical features of 3 foamy PanIN lesions were compared with those of 7 pancreatic foamy gland adenocarcinomas. Hematoxylin and eosin, Mayer mucicarmine, periodic acid-Schiff, and Alcian blue stains were available for review in all cases. Immunohistochemical labeling for cytokeratin (CK)7, CK20, carcinoembryonic antigen polyclonal, MUC1, MUC2, CDX2, p53, and cyclin D1 was performed. The PanIN-1 lesions were found in the nonneoplastic pancreas and were similar to the PanIN-1 lesions of ordinary pancreatic ductal carcinoma. The PanIN-2 and -3 lesions were recognized immediately adjacent to or within the invasive foamy gland carcinoma. In these lesions, small or markedly dilated ducts were lined by cuboidal and columnar dysplastic nonfoamy cells and foamy cells. Hobnail cells were present in 2 cases. The PanIN-1, 2, and 3 lesions and the invasive foamy gland adenocarcinomas stained with mucicarmine, periodic acid-Schiff, and Alcian blue. The 3 PanIN-2 and -3 lesions and all 7 invasive foamy adenocarcinomas labeled with CK7, carcinoembryonic antigen polyclonal, and MUC1, whereas only 2 PanIN-2 and -3 lesions and 5 invasive adenocarcinomas showed immunoreactivity for cyclin D1 and p53. Three distinctive foamy PanIN lesions were identified within 7 invasive foamy gland pancreatic adenocarcinomas. The gradual progression of cytological and architectural abnormalities of the PanIN lesions from PanIN-1 to PanIN-3 excludes neoplastic ductal spread. These foamy PanIN lesions probably represent cancer precursors. (C) 2008 Elsevier Inc. All rights reserved.