Gastric carcinoid in the absence of atrophic body gastritis and with low Ki67 index: a clinical challenge

Abstract Background. Gastric carcinoids (GCs) represent 23% of all digestive neuroendocrine tumors (NETs). They can be distinguished into three types: type I (in the presence of atrophic body gastritis, ABG), type II (in the presence of Zollinger-Ellison/multiple endocrine neoplasia type I syndrome)...

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Bibliographic Details
Published in:Scandinavian journal of gastroenterology 2014-04, Vol.49 (4), p.506-510
Main Authors: Lahner, Edith, Pilozzi, Emanuela, Esposito, Gianluca, Galli, Gloria, Annibale, Bruno
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy
Carcinoid Tumor - chemistry
Carcinoid Tumor - classification
Carcinoid Tumor - diagnosis
Carcinoid Tumor - pathology
Endoscopy, Digestive System
Female
Humans
Immunohistochemistry
Italy
Ki-67 Antigen - analysis
Male
Middle Aged
Prevalence
Retrospective Studies
Stomach Neoplasms - chemistry
Stomach Neoplasms - classification
Stomach Neoplasms - diagnosis
Stomach Neoplasms - pathology
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Summary:Abstract Background. Gastric carcinoids (GCs) represent 23% of all digestive neuroendocrine tumors (NETs). They can be distinguished into three types: type I (in the presence of atrophic body gastritis, ABG), type II (in the presence of Zollinger-Ellison/multiple endocrine neoplasia type I syndrome), type III (sporadic carcinoids, without any background pathology). Aim. To describe a case of undetermined type of GCs in an Italian referral center for NETs and its prevalence among GCs during a 6-year period. Results. In a case series of 16 GCs seen at our unit between 2007 and 2012, 14 (83.3%) patients had type I carcinoid and 1 patient (6.2%) had type III carcinoid. One patient did not accomplish to the actual classification criteria. This patient had a well-differentiated carcinoid with low Ki67, but multiple gastric biopsies performed at 3-year follow-up gastroscopies excluded the presence of ABG. The patient had fundic cystic polyps, suggesting long-term use of proton pump inhibitors, possibly associated with GCs. Conclusions. This case shows that a GC may occur in the absence of ABG and with low Ki67 index, making classification according to actual criteria difficult. Further studies are needed to better understand the occurrence of this particular type of GCs.
ISSN:0036-5521
1502-7708
DOI:10.3109/00365521.2013.878381