Neşe Çallı DEMİRKAN, Murat ÖZBAN, Hatice KUZULAR

Ampulla vaterinin primer taşlı yüzük hücreli karsinomu: Olgu sunumu ve literatür özeti

Özet Ampulla vaterinin taşlı yüzük hücreli karsinomu, adenokarsinomun nadir bir varyantıdır. Taşlı yüzük morfolojisindeki hücreler; intrasitoplazmik müsin içeren berrak sitoplazmalı, hiperkromatik, ekzantrik nükleuslu hücrelerdir. Bazı çalışmalarda immunohistokimyasal sonuçlara göre ampuller taşlı yüzük hücreli karsinom intestinal, pankreatobiliyer ve mikst tip olmak üzere üç subtipe ayrılmıştır. Bazı yayınlarda dördüncü tip olarak gastrik tipten de söz edilmektedir. Bu çalışmada 60 yaşında erkek hastada ampulla vateri yerleşimli taşlı yüzük hücreli karsinom olgusunu sunduk. Duodenum müsküler duvarını infiltre eden taşlı yüzük morfolojisindeki hücrelerde PAS-Alcian Blue ile intrasitoplazmik müsin birikimi tespit edildi. İmmunohistokimyasal incelemede taşlı yüzük hücrelerinde MUC1, MUC2, CK19, CK20, CDX2 pozitif; CK7 fokal pozitif; MUC5AC yer yer zayıf pozitif saptandı. İntestinal tip ile ilişkili MUC2, CK20, CDX2 antikorlarının ve pankreatobiliyer tip ile ilişkili CK7, CK19, MUC1 antikorlarının bir arada pozitifliği nedeniyle olgu mikst tip ampulla vateri taşlı yüzük hücreli karsinomu lehine değerlendirildi ve literatür ışığında prognoz ve tedavi açısından tartışıldı. Anahtar sözcükler: Ampulla vateri, karsinom, taşlı yüzük hücresi.

Anahtar Kelimeler:

ampulla vateri, karsinom, taşlı yüzük hücresi

Primary signet ring cell carcinoma of ampulla of vater: Report of a case and a review of the literature.

AbstractSignet ring cell carcinoma of the ampulla of vater is a rare variant of adenocarcinoma. Morphology of the signet ring cell carcinoma is defined as intracytoplasmic mucin, with clear cytoplasm and hyperchromatic, eccentric nucleus. It is divided into three subtypes as intestinal, pancreatobiliary and mixed type according to immunohistochemical findings. Gastric type is mentioned as the fourth type by other publications. In this study, signet ring cell carcinoma of ampulla vater in a 60-year-old male patient is presented. Intracytoplasmic mucin accumulation was detected with PAS-Alcian Blue in cells that infiltrating the muscular wall of the duodenum. Immunohistochemically MUC1, MUC2, CK19, CK20, CDX2 positive; CK7 focal positive; MUC5AC locally weak positive detected in tumor cells. Because of coexistence MUC2, CK20, CDX2 antibodies associated with the intestinal type and CK7, CK19, MUC1 antibodies associated with pancreatobiliary type, the case was evaluated in favor of mixed type signet ring cell carcinoma of ampulla and discussed in terms of prognosis and treatment in the light of the literature. Key words: Ampulla of vater, carcinoma, signet ring cell.

Keywords:

ampulla of vater, carcinoma, signet ring cell,

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