Duodenal gastrinomas do not seem to behave as malignantly as sporadic pancreatic gastrinomas. Statistical analysis of 49 patients with sporadic pancreatic gastrinoma and 21 patients with sporadic duodenal gastrinoma reported since 1980 in Japan revealed that the incidence of hepatic metastasis was 57% in patients with sporadic pancreatic gastrinoma and only 9% in patients with sporadic duodenal gastrinoma (p less than 0.01). These findings suggest that there is an essential biological differences between duodenal and pancreatic gastrinoma. Five patients with sporadic duodenal microgastrinoma (tumor diameter less than 5mm) in our hospital had no hepatic metastases; however, 4 patients had lymph node metastases. Immunohistochemical study of 5 sporadic duodenal microgastrinomas and 6 sporadic pancreatic gastrinomas revealed that the sporadic duodenal gastrinomas contained significantly fewer insulin-producing or glucagon-producing cells than sporadic pancreatic gastrinomas. The cellular composition of the metastatic lymph nodes from duodenal microgastrinomas was similar to that of the primary tumor. This difference in cellular composition between the duodenal microgastrinomas and the pancreatic gastrinomas suggests that the process of development and differentiation of gastrinoma cells is different.

Adult↗

PubMedDate not supplied

Gut-endocrinomas (carcinoids and related endocrine variants) of the breast: an analysis of 310 reported cases.

The purpose of this study was to analyze the present status of gut-endocrinomas (carcinoids and related endocrine variants) of the breast, an extremely rare site for primary growth of such neoplasms, and to provide precise and reliable information concerning these neoplasms on varying clinicopathological aspects for investigators engaged in relevant research fields. A total of 310 cases presented in this analysis consisted of 196 carcinoids, 102 typical and 94 atypical, and 114 related endocrine variants; in the last group, the expression of "breast carcinoma with (neuro-) endocrine differentiation" was often used without referring to the term "carcinoid." A statistical evaluation was performed on most occasions based on a comparison among three groups of typical carcinoids, atypical carcinoids and related endocrine variants, or between the former two series of carcinoids and the third series of endocrine carcinomas. Statistically significant differences between the groups of carcinoids and endocrine carcinomas were recognized in terms of average age, tumor size categories of < or = 20 mm and 21-50 mm, rates of metastases, and positive neuron-specific enolase (NSE) immunohistochemistry. Contrary to our expectations no statistically significant difference between these two groups was evident in terms of overall average tumor size, Grimelius argyrophilia for endocrine nature, or postoperative 5-year survival rates in curative resection cases. It seems important to establish more precise diagnostic criteria for "endocrine carcinomas" from the viewpoint of a certain possibility that some of these neoplasms may belong to the atypical carcinoid group.

Aged↗

PubMedDate not supplied

Carcinomas involving the esophagogastric junction.

In order to avoid confusion in categorizing malignant lesions for surgical treatment, a definition and criteria of carcinomas significantly involving the esophagogastric junction (ECJ-Ca) and those of gastric cardia less significantly involving the esophagogastric junction (eC-Ca) are proposed, devised as this study was from a practical viewpoint. A comparative analysis of carcinomas of these groups was carried out, the control group being those carcinomas situated mainly in the upper third segment of the stomach but not involving the esophagogastric junction (C-Ca). Carcinomas of these regions can be determined by the EGJ-Index (EGJ-I) calculated through the following formula: EGJ-Index = [( Length of the esophageal portion of the lesions)/(length of the of the esophageal portion + gastric portion of the lesion])x1,000. Thus lesions of these regions are easily and practically classified as follows: [I]: EGJ-Ca 250 less than or equal to EGJ-I less than or equal to 750, 59 cases; ( II]: eC-Ca 0 less than or equal to EGJ-I less than 250, 88 cases; [III]: C-Ca 0 = EGJ-I, 208 cases. We found these categories quite suitable for practical use.

Carcinoma↗

PubMedDate not supplied

Carcinomas involving the esophagogastric junction (EGJ-Ca). A reevaluation of the criteria.

The present study aims to elucidate more clearly the definition and criteria for carcinomas involving the esophagogastric junction (EGJ-Ca) from a practical viewpoint based on the concept that an EGJ-Ca is a separate surgical disease entity different from either a lower-esophageal or an upper-gastric carcinoma. Among a series of 397 cases of upper-gastric carcinoma and EGJ-Ca resected during a 31-year period between 1963 and 1993, 79 patients with EGJ-Ca (EGJ-Index ranging between 250 and 750) were selected according to lesions with the central point confined within the EGJ-zone 20 mm each proximal and distal to the EGJ-line. Selected for the control group were 97 patients with upper-gastric carcinoma that was strictly confined within the upper third segment of the stomach without involving the EGJ-line upward or the middle third segment downward and with the central point of lesions outside the EGJ-zone. The comparative analysis indicated that an EGJ-Ca might be well defined not only by the EGJ-Index, but also by the EGJ-zone and the localization of the central points of lesions confined within the EGJ-zone. The definition and criteria for EGJ-Ca were thus modified from those of the previous proposal and proposed in this study with three main factors: (1) the EGJ-Index, (2) the EGJ-zone, and (3) the localization of the central point of lesions.

Adult↗