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Primary duodenal neoplasms:A retrospective clinico-pathological analysis

World Journal of Gastroenterology 2007年第7期13卷 1108-1111页

作者： Amanjit Bal kusum joshi Kim Vaiphei JD Wig Departments of Histopathology and General Surgery Post Graduate Institute of Medical Sciences and Research Sector-12 Chandigarh 160012 India

AIM: To analyze the clinico-pathological spectrum of primary duodenal neoplasms. METHODS: A total of 55 primary duodenal neoplasms reported in the last 10 years after excluding ampullary and periampullary tumors were included in the study. Clinical details were noted and routine hematoxylin and eosin stained paraffin sections were studied for histological subtyping of the tumors. RESULTS: On histopathological examination primary duodenal neoplasms were categorized as: epithelial tumor in 27 cases (49.0%) including 10 cases of adenoma, 15 cases of adenocarcinoma, and 2 cases of Brunner gland adenoma; mesenchymal tumor in 9 cases (16.3%) consisting of 4 cases of gastrointestinal stromal tumor, 4 cases of smooth muscle tumor and I case of neurofibroma; lymphoproliferative tumor in 12 cases (21.8%), and neuroendocrine tumor in 7 cases (12.7%). CONCLUSION: Although non-ampullary/periampullary duodenal adenocarcinomas are rare, they constitute the largest group. Histopathological examination of primary duodenal tumors is important for correct histological subtyping.

关键词： Duodenum Adenocarcinoma Stromal tumor Neuroendocrine tumor Lymphoma

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Roles of syndecan-1, bcl6 and p53 in diagnosis and prognostication of immunoproliferative small intestinal disease

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World Journal of Gastroenterology 2006年第22期12卷 3602-3608页

作者： Kim Vaiphei Neeraj Kumari Saroj Kant Sinha Usha Dutta Birinder Nagi kusum joshi Kartar Singh Department of Histopathology PGIMER ChandigarhIndia Department of Gastroenterology PGIMER ChandigarhIndia

AIM： To evaluate roles of syndecan-1, bcl6 and p53 in diagnosis and prognostication of immunoproliferative small intestinal disease （IPSID） and to study profiles of kappa （κ） and lambda （λ） light chains and IgA heavy chain. METHODS： The study consisted of 11 cases of IPSID and similar number of controls which included 11 of normal intestinal mucosa and 11 of high grade B cell lymphoma of ileum. The parameters analyzed included clinical profiles, biochemical and other laboratory investigations, radiologic and histological findings including immunohistochemistry. RESULTS： All IPSID cases had demonstrable serum IgA heavy chain and heavy mucosal plasma cell infiltration. According to Galian＇s histological staging, there were 4 patients with stage A and 7 with stage B. κ and ;λ light chains were over-expressed in 7 patients; 1 stage A patient had H pylori-positive active gastritis and eradication of H pylori led to disease remission. Stage A biopsies had higher expression for syndecan-1, while stage B had higher expression for bcl6 and p53. Syndecan-1,κ and λ light chains and IgA heavy chain showed inverse relationship with bcl6 and p53. All patients were treated with doxycycline. CHOP regime was added in 5 patients who developed frank lymphoma. Three died of the disease due to extensive organ infiltration. CONCLUSION： Certain immunomarkers like syndecan-1,κ and λ light chains and IgA heavy chain could be of much help in identifying early stage IPSID. Stage B IPSID showed higher expression for bcl6 and p53 than stage A IPSID. bcl6 and p53 expressions correlated with a more advanced disease stage and aggressive tumour behavior.

关键词： IPSID Syndecan-1 bcl6 p53 protein κ and λ light chains Alpha heavy chain H pylori

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