十二指腸の幽門腺腺腫です。定型例ならほぼ全例がGNAS/KRAS/APCに変異のある奴です。十二指腸の粘液腺はブルンネル腺ですが、Brunner gland adenomaという名称はrecommendされていません。幽門腺腺腫といっても胃では胃底腺領域に発生します。頚部粘液細胞や偽幽門腺化生に関連しているからです。胃癌取扱い規約では「胃型腺腫」と名付けられています。Pyloric gland adenoma (PGA)はmisnomerだろうと、先日もオーストリアの病理医からイチャモンをつけられました。歴史的・文献的にいうと説明が長くなりますので省略しますが、英文誌上ではPGAが通称になっています。
It is a pyloric gland adenoma (PGA) of the duodenum. Almost all typical cases have mutations in GNAS/KRAS/APC. The mucous glands of the duodenum are called Brunner's glands, but the name Brunner gland adenoma is not recommended. Although this type of tumor is called “pyloric gland” adenoma, it usually occurs not in the pyloric gland area but in the fundic-gland (oxyntic gland) area in the stomach. PGAs arise in relation to mucous neck cells and pseudo-pyloric gland metaplasia. PGA must be a misnomer, as claimed by an Austrian friend the other day. I'll skip the historical and literary explanation, but PGA is the common name and globally used in English journals.
MUC6が表層以外に陽性です。MUC6 is positive except for the superficial layer.
MUC5ACは表層主体に染まります（内部にもパラパラ染まります）。
MUC5AC is mainly stained on the surface layer (it is also partly stained in the deeper part).
本例では表層の胃腺窩上皮型細胞（MUC5AC陽性）のところに、adipophilinもよく染まっています。adipophilinは脂肪滴の膜蛋白に染まるといわれ、lipid accumulationのマーカーとされています。胃腺窩上皮型細胞は吸収上皮ではないので、おそらく何らかの脂質が異常に蓄積されているのだと考えられます。例えば、分野は異なりますが、スズちゃんが乳腺のアポクリン化生やアポクリン化生がんにadipophilinが染まることを10年も前にAJSPに記載しています。なお、adipophilinが染まっているところにはCD10もCDX2も陰性です。
In this case, the gastric-foveolar type cells in the superficial layer (MUC5AC-positive) are also stained with adipophilin, which is a marker of lipid accumulation staining the membrane proteins of fat droplets. Gastric-foveolar type cells are not absorptive epithelium, so this finding probably shows an abnormal accumulation of some lipid. For example, although in a different field, Suzu described in AJSP 10 years ago that adipophilin stains apocrine metaplasia and apocrine carcinomas of the breast. In addition, both CD10 and CDX2 are negative where adipophilin is present in the present case.
C11 190号機が青部駅を補機なしで力行です。会心の作品です（2021-9-26 雨）。
C11 190 fährt ohne die Hilfe einer EL durch den Bahnhof Aobe. Gutes Bild!! (26.9.2021. Regen )
It is a pyloric gland adenoma (PGA) of the duodenum. Almost all typical cases have mutations in GNAS/KRAS/APC. The mucous glands of the duodenum are called Brunner's glands, but the name Brunner gland adenoma is not recommended. Although this type of tumor is called “pyloric gland” adenoma, it usually occurs not in the pyloric gland area but in the fundic-gland (oxyntic gland) area in the stomach. PGAs arise in relation to mucous neck cells and pseudo-pyloric gland metaplasia. PGA must be a misnomer, as claimed by an Austrian friend the other day. I'll skip the historical and literary explanation, but PGA is the common name and globally used in English journals.
MUC6が表層以外に陽性です。MUC6 is positive except for the superficial layer.
MUC5ACは表層主体に染まります（内部にもパラパラ染まります）。
MUC5AC is mainly stained on the surface layer (it is also partly stained in the deeper part).
本例では表層の胃腺窩上皮型細胞（MUC5AC陽性）のところに、adipophilinもよく染まっています。adipophilinは脂肪滴の膜蛋白に染まるといわれ、lipid accumulationのマーカーとされています。胃腺窩上皮型細胞は吸収上皮ではないので、おそらく何らかの脂質が異常に蓄積されているのだと考えられます。例えば、分野は異なりますが、スズちゃんが乳腺のアポクリン化生やアポクリン化生がんにadipophilinが染まることを10年も前にAJSPに記載しています。なお、adipophilinが染まっているところにはCD10もCDX2も陰性です。
In this case, the gastric-foveolar type cells in the superficial layer (MUC5AC-positive) are also stained with adipophilin, which is a marker of lipid accumulation staining the membrane proteins of fat droplets. Gastric-foveolar type cells are not absorptive epithelium, so this finding probably shows an abnormal accumulation of some lipid. For example, although in a different field, Suzu described in AJSP 10 years ago that adipophilin stains apocrine metaplasia and apocrine carcinomas of the breast. In addition, both CD10 and CDX2 are negative where adipophilin is present in the present case.
C11 190号機が青部駅を補機なしで力行です。会心の作品です（2021-9-26 雨）。
C11 190 fährt ohne die Hilfe einer EL durch den Bahnhof Aobe. Gutes Bild!! (26.9.2021. Regen )
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