Inappropriate mucin production in gall bladder metaplasia and neoplasia–an immunohistological study

Abstract

This study demonstrates the presence of three antigens in glandular metaplasia occurring in patients with cholecystitis and cholelithiasis: specifically carcinoembryonic antigen (CEA), large intestinal mucin antigen (LIMA) and small intestinal mucin antigen (SIMA). These antigens could not be detected in normal gall bladder mucosa or in squamous metaplasia of the gall bladder. The occurrence of the three intestine-associated antigens in three carcinomas was irregular. In one mucinous carcinoma, only SIMA could be demonstrated. In one adenocarcinoma, SIMA was present in small areas of mucinous change, whilst CEA was present in the non-mucinous malignant tissue. In a mixed mucinous and non-mucinous adenocarcinoma with widespread dissemination, the three antigens were present both in the primary tumour and the metastases. These observations suggest that all forms of glandular metaplasia of the gall bladder are intestinal in nature and at least a proportion of gall bladder carcinomas are of an intestinal type. Finally they provide further immunological evidence that glandular metaplasia of the gall bladder should be considered a pre-malignant condition.

Sclerotherapy of Edematous Gallbladders with Different Agents

“…The frequency of metaplastic epithelium in diseased, nontumorous gallbladders is high, 72.8%, according to LAITIO (17). Several authors have found antral-type metaplasia in association with gallbladder carcinoma in man (3,10,16,22) and 2 mucinous carcinomas were bordered by antral-type mucosa (16). Mucinous metaplasia has therefore been considered a possible premalignant condition.…”

Distribution of gland-like structures in human gallbladder adenocarcinomas possesses fractal dimension

“…Tumor cells had to be neutral mucin-positive, N-acetylsialomucin-positive, sulphomucin-negative, O-acetylsialomucin-negative, and CEA-positive, where distribution of the antigens was glandular, (i.e., the antigens were present within a lumen of the gland-like structure) or apical (i.e., the antigens were dispersed along the luminal surface of cells in the gland-like structure) [9][10][11][12][13]. A pattern was classified as a well-differentiated adenocarcinoma (G1) if it was composed of well-formed small glands similar to those in normal mucosa.…”

Distribution of gland-like structures in human gallbladder adenocarcinomas possesses fractal dimension

“…To construct relatively homogenous groups of gallbladder adenocarcinomas, a number of tumors previously enrolled in the data bank as well-differentiated adenocarcinomas (G1) or moderately differentiated adenocarcinomas (G2) were carefully reexamined. Tumor cells had to be neutral mucin-positive, N-acetylsialomucin-positive, sulphomucin-negative, O-acetylsialomucin-negative, and CEA-positive, where distribution of the antigens was glandular, (i.e., the antigens were present within a lumen of the gland-like structure) or apical (i.e., the antigens were dispersed along the luminal surface of cells in the gland-like structure) [9][10][11][12][13]. A pattern was classified as a well-differentiated adenocarcinoma (G1) if it was composed of well-formed small glands similar to those in normal mucosa.…”