Gastric Neuroendocrine Tumor With Pancreatic Acinar Cell Differentiation in the Background of Atrophic Gastritis: A Possible Variant of Type 1 ECL-Cell NET-A Case Report.

IF 2.5 4区医学 Q2 PATHOLOGY

Pathology International Pub Date : 2025-05-06 DOI:10.1111/pin.70022

Tomoko Norose, Nobuyuki Ohike, Misato Tsukada, Yoshiya Sugiura, Hirotaka Koizumi, Yusuke Nakamoto, Keisuke Tateishi, Shinya Mikami, Junki Koike

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引用次数: 0

Abstract

A gastric neuroendocrine tumor (NET) with pancreatic acinar cell differentiation is extremely rare. We report the case of an 87-year-old woman with a submucosal tumor in the gastric body on a background of atrophic gastritis. She also had Sjögren's syndrome. Initially 17.8 × 6.5 mm, the tumor enlarged over 10 years, leading to wedge resection. The resected mass (45 × 40 × 30 mm) was solid with a pale yellow to gray-white cut surface. Histologically, it showed trabecular or solid nests of epithelial cells with round nuclei and eosinophilic cytoplasm. Immunohistochemistry showed positivity for CKAE1/3, VMAT2, neuroendocrine markers, and pancreatic acinar markers. Ki-67 index was 11.2%. The tumor co-expressed PDX1 and ARX and showed loss of menin and ATRX. These findings support a diagnosis of gastric ECL-cell NET G2 arising in autoimmune gastritis, with secondary pancreatic acinar differentiation. This tumor may represent a variant of type 1 gastric NET.

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萎缩性胃炎背景下胃神经内分泌肿瘤伴胰腺腺泡细胞分化：1型ecl细胞NET-A可能的变异病例报告。

胃神经内分泌肿瘤伴胰腺腺泡细胞分化是极为罕见的。我们报告一个87岁的妇女与胃粘膜下肿瘤的背景萎缩性胃炎。她还患有Sjögren综合症。最初为17.8 × 6.5 mm，肿瘤扩大超过10年，导致楔形切除。切除肿物（45 × 40 × 30 mm）实心，切面淡黄至灰白色。组织学上，上皮细胞呈小梁状或实性巢状，核圆，胞浆嗜酸性。免疫组化显示CKAE1/3、VMAT2、神经内分泌标志物、胰腺腺泡标志物阳性。Ki-67指数为11.2%。肿瘤共表达PDX1和ARX，显示menin和ATRX的缺失。这些发现支持自身免疫性胃炎中出现的胃ecl细胞NET G2的诊断，伴有继发性胰腺腺泡分化。该肿瘤可能是1型胃NET的一种变体。

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来源期刊

Pathology International 医学-病理学

CiteScore

4.50

自引率

4.50%

发文量

102

审稿时长

12 months

期刊介绍： Pathology International is the official English journal of the Japanese Society of Pathology, publishing articles of excellence in human and experimental pathology. The Journal focuses on the morphological study of the disease process and/or mechanisms. For human pathology, morphological investigation receives priority but manuscripts describing the result of any ancillary methods (cellular, chemical, immunological and molecular biological) that complement the morphology are accepted. Manuscript on experimental pathology that approach pathologenesis or mechanisms of disease processes are expected to report on the data obtained from models using cellular, biochemical, molecular biological, animal, immunological or other methods in conjunction with morphology. Manuscripts that report data on laboratory medicine (clinical pathology) without significant morphological contribution are not accepted.