Mucinous adenocarcinoma is a rare histologic type of gastric carcinoma. Most mucinous gastric carcinoma is diagnosed by histology after surgical resection. However, in this report, we preoperatively predicted the type of a tumor (mucinous type) from its characteristic endoscopic finding. An endoscopic examination showed a cauliflower-like mass on the upper body of the posterior wall. At first we could not find the mass because it was covered with a thick mucin-like substance. After gastric lavage and mucin aspiration we found a tumor mass which was surrounded with a characteristic mucin pool. Abdominal CT showed a 6 cm sized-mass connected with the gastric fundus. Total gastrectomy with esophagojejunostomy was performed. The pathology of the tumor proved to be a mucinous adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Gastrectomy ; Gastric Fundus ; Gastric Lavage ; Gastric Mucins* ; Mucins* ; Pathology ; Tomography, X-Ray Computed

A gastric carcinoma with the endoscopic features resembling submucosal tumor (SMT) is rare, and reportedly account for only 0.1% to 0.63% of all resected gastric carcinomas. The preoperative diagnosis of SMT-like gastric carcinoma is challenging, and thus, diagnosis is usually made intraoperatively or postoperatively. Furthermore, mucinous adenocarcinoma is an uncommon histologic subtype of gastric carcinoma characterized as an elevated lesion resembling SMT due to abundant mucin pools in submucosa. Here, we report two cases in which a gastric mucinous adenocarcinoma was mistaken as a SMT.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Gastric Mucins ; Mucins ; Stomach ; Stomach Neoplasms

PURPOSE: To evaluate CT findings of mucinous adenocarcinoma in the gastrointestinal tract. MATERIALS AND METHODS : CT scans of 24 gastric and five colorectal mucinous adenocarcinomas, proven by histology, were retrospectively analysed; the patients consisted of 18 men and 11 women (age range, 27-76; mean, 59). CT findings were analysed, with emphasis on : (a) tumor size and maximal wall thickness ; (b) the presence of a low attenuation area, suggestive of a mucin poll within the tumor ; (c) the presence, shape and location of calcification, and (d) correlation between primary tumor (T) staging and CT findings. RESULTS: The mean tumorsize of gastric mucinous adenocarcinoma was 8.2cm (range, 1.4 - 17cm) and the mean maximal wall thickness was2.3cm (range, 1-4.5cm). Low attenuation areas on enhanced CT were seen in 12 cases (50%). Mottled, punctate, diffuse calcifications were demonstrated in nine cases(38%), and were located in low attenuation areas in eight cases. The T staging could be determined in 22 cases. Of there, low attenuation areas were demonstrated in tencases and calcification in seven. Of those ten cases with low atteuation area T staging was T2 in two cases, T3 intwo, and T4 in six. Of the cases showing calcification, T staging was T3 in one case and T4 in six. The mean sizeof colorectal mucinous adenocarcinoma was 6cm(range, 3-13cm) and the mean maximal wall thickness was 3.6cm (range,1.5-7cm). Low attenuation area were seen in three cases. Mottled calcification within the low sttenuation was detected in one case. The T staging of three cases which showed a low attenuation area was T3 in tow cases and T4in one case. One case with calcification was T3 stage. CONCLUSION: The CT finding of mucinous adenocarcinoma inthe gastrointestinal tract was a relatively thick-walled mass containing an area of low attenuation or calcification. Although calcification is believed to be a pathognomonic finding for the specific diagnosis of mucinous adenocarcinoma, a low attenuation area may be an important CT finding because it can be detected at lower T staging and more frequently.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Diagnosis ; Female ; Gastric Mucins ; Gastrointestinal Tract* ; Humans ; Male ; Mucins* ; Tomography, X-Ray Computed

Muinous gastric carcinoma (MGC) is a rare histological type that accounts for approximately 3~7% of all gastric carcinomas. The results of clinicopathological studies suggest that the overall survival rate for patients with MGC is worse than that for patients with non-mucinous tumors as MGC is more frequently diagnosed in the advanced stage. In this report, we preoperatively predicted the type of a tumor from its endoscopic finding. An endoscopic ultrasonographic examination showed a submucosal tumor like mass showing mucin waterfall on the gastric cardia. A total gastrectomy with splenectomy was performed. The pathology of the tumor identified the lesion as a mucinous adenocarcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Cardia ; Gastrectomy ; Gastric Mucins ; Humans ; Mucins ; Splenectomy ; Survival Rate

BACKGROUND: Helicobacter pylori colonizes the gastric surface epithelium and the mucus gel layer. It has been known that H. pylori infection decreased the gastric mucin expression. The aim of this study was to determine the effect of H. pylori eradication on mucin expression (MUC5AC, MUC6 and MUC1) in the gastric epithelium. METHODS: This study included 20 patients positive for H. pylori whom successful eradication was performed between March 1998 and December 1999. H. pylori status was determined by histology, rapid urase test and urea breath test. Gastric antral biopsy specimens were examined by immunohistochemistry for mucin (MUC5AC, MUC6 and MUC1) expression. The distribution of epithelial cells expressing MUC5AC was calculated at two sites (surface mucous cells, pyloric glands). Two scores system (weak-strong) was used to assess staining intensity. RESULTS: There was a gradient of MUC5AC expression, higher to lower from the surface to the glands. Increased MUC5AC expression in the surface mucous cell (p=0.013) and in the glands (p=0.008) was found after H. pylori eradication. MUC6 and MUC1 distribution was not changed after H. pylori eradication. CONCLUSION: MUC5AC expression was increased after H. pylori eradication. These results suggest that MUC5AC may relate in the pathogenesis of H. pylori.
Biopsy ; Breath Tests ; Colon ; Epithelial Cells ; Epithelium ; Gastric Mucins ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunohistochemistry ; Mucins* ; Mucus ; Urea

OBJECTIVETo explore a method which can remove the gastric mucus in order to prepare mucous membrane single cell suspension for the research of cytomics.

METHODSEnzymology was used to remove the mucus gel and to separate mucous layer from the normal fresh gastric tissue. The mucous layer was broken to prepare single cell suspension with machine method. Expression of major cyclins in mucous layer cells was examined by cytoimmunochemistry, flow cytometry(FCM) and confocal microscopy.

RESULTSThe 0.1% pepsin could dissolve the mucus gel and 1.2-2.4 U/L dispase could separate the mucous layer completely. The single mucous cell suspension was prepared successfully. FCM results from mucous single cell suspension revealed that expression of cyclin D(3), B(1) was obvious, that of cyclin D(2) was weak and that of cyclin D(1), A, E was the least. Similar results were found with confocal microscopy.

CONCLUSIONSSingle cell suspension from mucous layer can be easily prepared by pepsin and dispase. Cyclins schedule expression in vivo is different from cyclins schedule expression in vitro.

Cell Line ; Cell Proliferation ; Cyclins ; metabolism ; Flow Cytometry ; Gastric Mucins ; metabolism ; Gastric Mucosa ; cytology ; metabolism ; Humans ; Mucous Membrane ; cytology ; metabolism

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.
Animals ; Ethanol ; Gastric Mucins ; Gastric Mucosa ; Gastritis ; Hot Temperature ; Immersion ; Indomethacin ; Mucus ; Pepsin A ; Peptic Ulcer ; Prolamins ; Rats ; Tea ; Ulcer ; Water

PURPOSE: Recent studies have shown that the expression of mucin is organ- and cell-type specific and it is increasingly possible that its change could result from oncogene activation.To evaluate histogenesis and prognostic factors for gastric carcinoma, we studied the oncoprotein expression in gastric cancer cells classified by mucin phenotye. MATERIALS AND METHODS: Mucin histochemistry and immunohistochemistry for ras, c-erbB2, and p53 oncoprotein expression were performed in 101 surgically resected gastric carcinoma specimens. PAS-Con A, GOS, and HID-AB staining techniques were employed in identifying mucosubstances, RESULTS: Of the 101 specimens studied, 73(72.3%) revealed as having mixture of various mucin-secreting cancer cells. Overall, ras immunoreactivity was observed in 72(71.3%), c-erbB2 in 7(6.9%), and p53 in 47(46.5%). Of the 73 mucus-secreting carcinomas, the surface mucous cell type were shown in 65 (89.0%), the pyloric gland cell type in 48(65,8%), the sialomucin type in 47(64.4%), and the sulfomucin type in 54(74.0%). There was significant association between mucin secretion and ras expression, but not c-erbB2 and p53 expression. There was no significant association between mucin secreting cell types and Lauren classification. Ras expression was correlated with serosal invasion, lymph node metastasis and poor prognosis. CONCLUSION: The phenotypic expression by mucin histochemistry may be not more important for studying of histogenesis in gastric carcinoma than Lauren classification. Ras expression is a poor prognostic indicator and may be correlated with phenotypic expression of surface mucous cell and intestinal cell type in gastric carcinoma.
Classification ; Gastric Mucosa ; Humans* ; Immunohistochemistry ; Lymph Nodes ; Mucins* ; Neoplasm Metastasis ; Oncogenes ; Prognosis ; Sialomucins ; Stomach Neoplasms

Gastric-type extremely well-differentiated adenocarcinoma (EWDA) is a rare type of gastric adenocarcinoma characterized by infiltration of well-formed mucinous glands with little or no nuclear atypia, which resemble foveolar epithelium or pyloric glands. Because of its high degree of differentiation, preoperative biopsy diagnosis of gastric-type EWDA is very difficult. We encountered a case of gastric-type EWDA, manifesting as a Borrmann type 4 lesion, in a 47-year-old man. Despite four repeated biopsies, the preoperative biopsy diagnosis was not conclusive due to the scarcity of diagnostic tumor cells and lack of knowledge regarding the unusual histologic findings of gastric-type EWDA. We herein describe the histologic findings of gastric-type EWDA in detail, with the aim of facilitating a preoperative biopsy diagnosis and understanding of this rare type of gastric adenocarcinoma.
Adenocarcinoma* ; Biopsy ; Diagnosis* ; Epithelium ; Gastric Mucosa ; Humans ; Middle Aged ; Mucins ; Stomach Neoplasms ; Stomach*

Intraductal papillary neoplasms of the bile duct (IPNBs) are known to show various pathologic features and biological behaviors. Recently, two categories of IPNBs have been proposed based on their histologic similarities to pancreatic intraductal papillary mucinous neoplasms (IPMNs): type 1 IPNBs, which share many features with IPMNs; and type 2 IPNBs, which are variably different from IPMNs. The four IPNB subtypes were re-evaluated with respect to these two categories. Intestinal IPNBs showing a predominantly villous growth may correspond to type 1, while those showing papillay-tubular or papillay-villous growth correspond to type 2. Regarding gastric IPNB, those with regular foveolar structures with varying numbers of pyloric glands may correspond to type 1, while those with papillary-foveolar structures with gastric immunophenotypes and complicated structures may correspond to type 2. Pancreatobiliary IPNBs that show fine ramifying branching may be categorized as type 1, while others containing many complicated structures may be categorized as type 2. Oncocytic type, which displays solid growth or irregular papillary structures, may correspond to type 2, while papillary configurations with pseudostratified oncocytic lining cells correspond to type 1. Generally, type 1 IPNBs of any subtype develop in the intrahepatic bile ducts, while type 2 IPNBs develop in the extrahepatic bile duct. These findings suggest that IPNBs arising in the intrahepatic ducts are biliary counterparts of IPMNs, while those arising in the extrahepatic ducts display differences from prototypical IPMNs. The recognition of these two categories of IPNBs with reference to IPMNs and their anatomical location along the biliary tree may deepen our understanding of IPNBs.
Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Bile ; Biliary Tract ; Cholangiocarcinoma ; Gastric Mucosa ; Mucins