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Benign glandular downgrowth in gastric neuroendocrine neoplasms: a potential mimic of composite tumour
Author(s) -
Ramineni Maheshwari,
Taggart Melissa W,
Rashid Asif,
Abraham Susan C
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12492
Subject(s) - submucosa , medicine , pathology , stomach , muscularis mucosae , gastroenterology
Aims We have observed glandular downgrowth in some gastric neuroendocrine tumours ( NET s), in which nonneoplastic appearing gastric glands are admixed with submucosal neuroendocrine nests, that could potentially be confused with composite tumours. Methods and results We reviewed 68 gastric NET s 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 NET s. Glandular downgrowth was present in 28 (41%) gastric NET s but only 2 (4.4%) duodenal NET s ( P < 0.0001). It was not related to age, gender, hypergastrinemia (downgrowth present in 43% of NET s arising in autoimmune gastritis, 41% of Zollinger–Ellison syndrome, 36% of sporadic NET s), tumour size, depth of invasion, or grade. Glandular downgrowth was confined to the submucosa even though 12 (18%) gastric NET s 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. Conclusions Our findings support the frequent occurrence and nonneoplastic nature of glandular downgrowth in gastric NET s, which should not be mistaken for composite tumours.