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Mitochondrion-rich differentiated adenocarcinomas of the stomach: clinicopathological, immunohistochemical and electron microscopy study of nine cases

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Abstract

Pathologic and prognostic data of nine patients with mitochondrion-rich carcinomas (MRC) were compared retrospectively to data of 101 patients with conventional gastric adenocarcinomas. MRC was defined as a tumour composed predominantly, or entirely, of columnar adenocarcinoma cells with eosinophilic cytoplasm and a strong supranuclear immunoreactivity for antimitocondrial antibody. Electron microscopy confirmed supranuclear distribution of mitochondria in MRC while immunostaining pattern was irregular or absent in the remaining 101 cases. MRC exhibited a tubulopapillary or cribriform growth pattern with focal infiltration of neutrophils in the tumour stroma. Prominent necrosis was present including segmental and intraluminal “dirty necrosis”, while mitotic and ki-67 proliferative rates were low. MRC showed immunohistochemical findings compatible with gastric differentiation (CK7+/CK20−/CDX−).When MRC were compared with non-MRC carcinomas, tumour size (<4 cm vs >4 cm, P < 0.01), frequency of lymph node metastases (11% vs. 80%, P < 0.01), low stage (I, II) at diagnosis (100% vs. 56%, P < 0.01), Goseki’s group I (100% vs. 6%, P < 0.01), and better survival (0% vs. 70%, P < 0.01) differed significantly. Our results suggest that MRC of the stomach may be considered a low-grade malignancy with an excellent prognosis.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Dipartimento di Patologia Umana, Policlinico Universitario, 98168, Messina, Italy

    Rosario A. Caruso, Alberto Nania & Francesco Fedele

  2. Dipartimento di Scienze Chirurgiche Generali e Speciali, Policlinico Universitario, 98168, Messina, Italy

    Antonino Parisi

  3. Servizio di Anatomia Patologica, Ospedale Piemonte, Messina, Italy

    Patrizia Napoli

  4. Istituto di Anatomia Patologica, Università degli Studi “Magna Grecia”, Catanzaro, Italy

    Valeria Zuccalà

Authors
  1. Rosario A. Caruso
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  2. Patrizia Napoli
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  3. Alberto Nania
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  4. Antonino Parisi
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  5. Francesco Fedele
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  6. Valeria Zuccalà
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Correspondence to Rosario A. Caruso.

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Caruso, R.A., Napoli, P., Nania, A. et al. Mitochondrion-rich differentiated adenocarcinomas of the stomach: clinicopathological, immunohistochemical and electron microscopy study of nine cases. Virchows Arch 456, 499–505 (2010). https://doi.org/10.1007/s00428-010-0912-x

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  • DOI: https://doi.org/10.1007/s00428-010-0912-x

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