Miller, Gregory C

Kumarasinghe, Marian P

Borowsky, Jennifer

Choi, Won-Tak

Setia, Namrata

Clauditz, Till

Gidwani, Raja

Sufiyan, Wajiha

Lauwers, Gregory Y

Brown, Ian S

2020-02

To determine the clinicopathological features of pyloric gland adenomas (PGA) that arise in the duodenum. 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. 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.

Envoi Specialist Pathologists, Brisbane, QLD, Australia.. Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia..

PathWest Laboratory Medicine, Perth, WA, Australia.. University of Western Australia, Perth, WA, Australia..

Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.. Pathology Queensland, Brisbane, QLD, Australia..

Department of Pathology, University of California at San Francisco, San Francisco, CA, USA..

Department of Pathology, University of Chicago, Chicago, IL, USA..

Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany..

GastroHealth, Miami, FL, USA..

Department of Pathology, Royal Darwin Hospital, Casuarina, NT, Australia..

Department of Pathology, H. Lee Moffitt Cancer Centre, Tampa, FL, USA.. Department of Pathology and Cell Biology and Oncologics, University of South Florida, Tampa, FL, USA..

Envoi Specialist Pathologists, Brisbane, QLD, Australia.. Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.. Pathology Queensland, Brisbane, QLD, Australia..

Histopathology 2020-02; 76(3): 404-410

0000-0002-1728-0825

0000-0002-9272-6700

0000-0002-6892-5881

0000-0002-6060-4717

https://pubmed.ncbi.nlm.nih.gov/31529725/?otool=iaurydwlib

https://hdl.handle.net/10137/8180

duodenum

immunohistochemistry

polyp

pyloric gland adenoma

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

Journal Article

Publication