Primary signet ring cell carcinoma of ampulla of vater: Report of a case and a review of the literature.

Yıl 2019, , 169 - 175, 18.01.2019

Hatice Kuzular , Neşe Çallı Demirkan , Murat Özban

https://doi.org/10.31362/patd.421184

Öz

Abstract

Signet ring cell carcinoma of the
ampulla of vater is a rare variant of adenocarcinoma. Morphology of the signet
ring cell carcinoma is defined as intracytoplasmic mucin, with clear cytoplasm
and hyperchromatic, eccentric nucleus. 
It is divided into three subtypes as intestinal, pancreatobiliary and
mixed type according to immunohistochemical findings. Gastric type is mentioned
as the fourth type by other publications. In this study, signet ring
cell carcinoma of ampulla vater in a 60-year-old male patient  is presented. Intracytoplasmic mucin accumulation was
detected with PAS-Alcian Blue in cells that infiltrating the muscular wall of
the duodenum. Immunohistochemically MUC1, MUC2, CK19, CK20, CDX2 positive; CK7 focal
positive; MUC5AC locally weak positive detected in tumor cells. Because of
coexistence MUC2, CK20, CDX2 antibodies associated with the intestinal type and
CK7, CK19, MUC1 antibodies associated with pancreatobiliary type, the case was
evaluated in favor of mixed type signet ring cell carcinoma of ampulla and
discussed in terms of prognosis and treatment in the light of the literature.

Key
words: Ampulla of vater, carcinoma, signet ring cell.

Anahtar Kelimeler

ampulla of vater, carcinoma, signet ring cell

Ampulla vaterinin primer taşlı yüzük hücreli karsinomu: Olgu sunumu ve literatür özeti

Öz

Özet

Ampulla vaterinin taşlı yüzük hücreli
karsinomu, adenokarsinomun nadir bir varyantıdır. Taşlı yüzük morfolojisindeki
hücreler; intrasitoplazmik müsin içeren berrak sitoplazmalı, hiperkromatik, ekzantrik
nükleuslu hücrelerdir. Bazı çalışmalarda immunohistokimyasal sonuçlara göre
ampuller taşlı yüzük hücreli karsinom intestinal, pankreatobiliyer ve mikst tip
olmak üzere üç subtipe ayrılmıştır. Bazı yayınlarda dördüncü tip olarak gastrik
tipten de söz edilmektedir. Bu çalışmada 60 yaşında erkek hastada ampulla vateri
yerleşimli taşlı yüzük hücreli karsinom olgusunu sunduk. Duodenum müsküler
duvarını infiltre eden taşlı yüzük morfolojisindeki hücrelerde PAS-Alcian Blue
ile intrasitoplazmik müsin birikimi tespit edildi. İmmunohistokimyasal
incelemede taşlı yüzük hücrelerinde MUC1, MUC2, CK19, CK20, CDX2 pozitif; CK7
fokal pozitif; MUC5AC yer yer zayıf pozitif saptandı. İntestinal tip ile ilişkili MUC2,
CK20, CDX2 antikorlarının ve pankreatobiliyer tip ile ilişkili CK7, CK19, MUC1 antikorlarının
bir arada pozitifliği nedeniyle olgu mikst tip ampulla vateri
taşlı yüzük hücreli karsinomu lehine değerlendirildi ve literatür ışığında prognoz
ve tedavi açısından tartışıldı.

Anahtar
sözcükler: Ampulla vateri, karsinom, taşlı yüzük hücresi.

Anahtar Kelimeler

ampulla vateri, karsinom, taşlı yüzük hücresi

Kaynakça

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