Malignant tumors of the small intestine: A histopathologic study of 41 cases among 1,312 consecutive specimens of small intestine

Department of Pathology, Shizuoka City Shimizu Hospital Shizuoka, Japan.
International journal of clinical and experimental pathology (Impact Factor: 1.89). 01/2012; 5(3):203-9.
Source: PubMed


There are few comprehensive studies of small intestinal malignancies. The author retrospectively reviewed 1,312 archival pathologic specimens of the small intestine in the last 10 years in our pathologic laboratory in search for malignant tumors of the small intestine. There were 22 cases (1.7%) of primary adenocarcinoma, 3 cases (0.2%) of primary squamous cell carcinoma, 6 cases (0.5%) of metastatic carcinoma, 6 cases (0.5%) of malignant lymphoma, 3 cases (0.2%) of carcinoid tumor, and 1 case (0.08%) of gastrointestinal stromal tumor (GIST). Of the 25 cases of primary adenocarcinoma and squamous cell carcinoma, 24 cases were located in the duodenum and 1 case in the ileum. The 22 cases of adenocarcinoma were classified into 7 well differentiated, 7 moderately differentiated, and 8 poorly differentiated adenocarcinomas. All the three squamous cell carcinomas were moderately differentiated ones with keratinization and intercellular bridges. In the 25 cases of carcinoma, immunoreactive p53 protein was present in 23 cases, and the Ki-67 labeling ranged from 40% to 95% with a mean of 76%. In the 6 cases of metastatic adenocarcinoma, the origin was ovary in 1 case, pancreas in 2 cases, gall bladder in 1 case, lung in 1 case, and colon in 1 case. In the 6 cases of lymphoma, 4 cases were diffuse large B-cell lymphomas and 2 cases were peripheral T-cell lymphomas. In the 3 cases of carcinoid tumor, all were typical carcinoids and immunohistochemically positive for at least one of neuroendocrine markers (chromogranin, synaptophysin, neuron specific enolase, and CD56). In the 1 case of GIST, the cell type is spindle and GIST cells were immunohistochemically positive for KIT and CD34. The histological risk was intermediate. Forty-one cases of small intestinal malignancies were reviewed histopathologically.

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    • "In intermediate risk group, tumor size is 5 cm < 10 cm, and mitotic counts are < 5/50 HPFs. In high risk group, tumor size is > 10 cm, and mitotic counts are > 10/50 HPFs[12,13]. Gastrointestinal leiomyomas are tumors arising from smooth muscle cells of muscularis mucosae , muscularis propria, or vessel-related smooth muscle cells. Microscopically these tumors are composed of spindle-shaped cells, similar to those of some GISTs, and can appear quite uniform in GIST as in leiomyoma. "
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    ABSTRACT: Objective: Some authors suggest common origin of gastrointestinal stromal tumors from stem cells, which may show diverse differentiation. There are reports in which cells morphologically identical to the interstitial cells of Cajal are found in deep leiomyomas. The aim of this study was to demonstrate CD117 positive cells in superficial gastrointestinal (GI) leiomyomas and to find other cells that would suggest diverse differentiation in histologically typical leiomyoma. Materials and methods: We analyzed 8 cases of superficial leiomyomas and one deep leiomyoma, received in our institutions as endoscopically or surgically obtained material. The tumor sections were immuno- histochemicaly stained with CD117, CD34, NF, S100, αSMA, desmin, caldesmon and mast cell antigen. Results: All leiomyomas showed diffuse positivity for αSMA, caldesmon and desmin. All of them had CD117 and CD34 positive cells morphologically identical to the interstitial cells of Cajal between smooth muscle fibers, 5 had S-100 and NF positive cells and 2 showed positivity for GFAP. The cells were found in different quantity; they were usually diffusely scattered through the tumors without predilection site, forming small groups in some areas. Conclusion: CD117, CD34, S-100 and NF positive cells are present in superficial leiomyomas and they may suggest common origin of GI stromal tumors. Keywords: Leiomyoma, Cajal cells, CD117, CD34, gastrointestinal tract
    Full-text · Article · Dec 2015 · International journal of clinical and experimental pathology
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    • "Among SI malignancies, squamous cell carcinomas (SCCs) are even more rare [11]. Only 3 cases (0.2%) of primary SCC were found in a recent analysis of 1.312 consecutive pathologic specimens of SI [11]. A review of the English literature revealed only three cases of squamous cell carcinoma of the small intestine (2 cases in the duodenum [7] [13], 1 case in the terminal ileum [12]). "
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    ABSTRACT: Squamous cell carcinoma arising from the small intestine is rare and difficult to identify as a primary or metastatic feature. We report a case of small intestinal squamous cell carcinoma manifesting as subacute peritonitis due to perforation. An 80-year-old man was admitted to our hospital with intermittent postprandial abdominal pain. He was diagnosed with acute peritonitis due to gastrointestinal perforation. During explorative laparotomy, a perforation site was detected in the jejunum and segmental resection to correct the perforation was performed including the perforation site located at the 70 cm inside the jejunum from the Treitz ligament. The pathology results revealed squamous cell carcinoma in the resected segment of the jejunum with two perforation sites.
    Full-text · Article · Oct 2014 · International journal of clinical and experimental pathology
    • "Primary adenocarcinoma of duodenum is a rare tumour, constituting 0.3-1% of all gastroinstestinal tumours with second part being the most common site of involvement[12]. Resection is the primary treatment for localized disease, with unresectable tumor having poorer prognosis than resectable ones.[3] "
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