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Duodenal gangliocytic paraganglioma with regional lymph node metastasis and a glandular component
Author(s) -
Ogata Sho,
Horio Takuya,
Sugiura Yoshiaki,
Aiko Satoshi,
Aida Shinsuke
Publication year - 2011
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2010.02620.x
Subject(s) - medicine , lymph node , lymph , pathology , paraganglioma , metastasis , pancreaticoduodenectomy , dissection (medical) , radiology , pancreas , cancer
Gangliocytic paraganglioma (GP) is generally considered to be a benign periampullary lesion, although it is unclear whether it should be classified as a hamartoma or as a neoplasm. Here, we present a GP case with lymph node metastasis. A 16‐year‐old boy complained of exertional dyspnea. Upper endoscopy and imaging studies revealed a polypoid ampullary tumor. Pancreaticoduodenectomy with lymph node dissection was performed due to swelling of peripancreatic lymph nodes. Histologically, the tumor consisted of three cell types: epithelioid; spindle; and ganglion cells. In addition to these typical components of GP, a distinct glandular component was also present. There was substantial invasion of tumor cells into the lymphovascular vessels, associated with lymph node metastases. These lymph node metastases were histologically similar to the primary tumor. To judge from these findings GP may be a true neoplasm with metastatic capacity. Pre‐ and intraoperative investigations for lymph node or distant metastases are required for adequate resection of this kind of tumor.