GASTRIC CARCINOID-TUMOR AND ITS PRECURSOR LESIONS - ULTRASTRUCTURAL-STUDY OF A CASE BEFORE AND AFTER ANTRECTOMY

Citation
T. Dadda et al., GASTRIC CARCINOID-TUMOR AND ITS PRECURSOR LESIONS - ULTRASTRUCTURAL-STUDY OF A CASE BEFORE AND AFTER ANTRECTOMY, Archives of pathology and laboratory medicine, 118(6), 1994, pp. 658-663
Citations number
28
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Journal title
Archives of pathology and laboratory medicine
ISSN journal
00039985 → ACNP
Volume
118
Issue
6
Year of publication
1994
Pages
658 - 663
Database
ISI
SICI code
0003-9985(1994)118:6<658:GCAIPL>2.0.ZU;2-7
Abstract
Antrectomy has been proposed as the preferential treatment of hypergas trinemic patients with nonantral gastric carcinoids since it removes t he main growth factor for the tumors and their precursor lesions, ie, hypergastrinemia. To investigate the cellular basis of the mechanism f or postantrectomy regression in nonantral endocrine cells, a light and electron microscopic morphometric study was performed in a case of en terochromaffinlike-cell gastric carcinoid associated with hypergastrin emia before and 4 and 10 months after antrectomy. The withdrawal of su stained hypergastrinemia obtained by antrectomy was associated with a progressive reduction of the volume density, cross-sectional area, and number of profiles of endocrine cells in the remaining nonantral muco sa, in which gastrin-dependent proliferations were regarded as the car cinoid precursor lesions. Ultrastructural morphometry demonstrated tha t the changes selectively involved the enterochromaffinlike cells, ie, the specific cell target for the trophic action of gastrin and the us ual component of gastric carcinoids. The volume fractions of enterochr omaffin and X cells (producing serotonin and endothelin, respectively) were increased 10 months after antrectomy. Persistence of a modest el evation of gastrin levels, likely due to the occurrence of gastrin cel ls in areas of pyloric metaplasia of the nonantral mucosa, did not pre vent the hypotrophic effects of antrectomy.