alcian-blue and Stomach-Neoplasms

A case of a Borrmann type 2 advanced gastric cancer with endocrine differentiation is described. Histologically, the cancer was either composed of cells arranged in a tubular pattern or formed solid nests of various sizes. The tubular pattern was composed of a moderately differentiated tubular adenocarcinoma. The histology showed partial carcinoid tumor-like features. Cancer cells inside solid nests had a signet-ring cell-like appearance. Periodic-acid Schiff (PAS) staining was positive in the cytoplasm of a few of the cells found in the tubular pattern and in the mucus in some lumens and on the apical surface of cells in some lumens, but PAS did not stain cancer cells in the solid nests. Neither cancer cells nor mucus in the lumens were stained with alcian blue. All cancer cells were strongly positive for Grimelius silver stain, and most of the cancer cells stained positively for chromogranin A. Electron microscopic examination showed electron dense neuroendocrine granules in the cytoplasm of cancer cells. Cancer cells were stained positively for pancytokeratin, cytokeratin 8/18 and carcinoembryonic antigen. Muc 1 mucin glycoprotein staining was positive along the cell surfaces of cancer cells, but Muc 2, 5AC and 6 stainings were negative, although Muc 3 stained positively in the cytoplasm of a few cancer cells. The present case is a gastric tubular adenocarcinoma with Muc 1-positive, neutral- and acid mucin-negative signet-ring cell-like cells, which is associated with neuroendocrine differentiation.

Topics: Adenocarcinoma; Aged; Alcian Blue; Carcinoma, Signet Ring Cell; Coloring Agents; Humans; Immunohistochemistry; Male; Mucins; Neurosecretory Systems; Periodic Acid-Schiff Reaction; Staining and Labeling; Stomach Neoplasms

Although the major histologic type in small gastric cancers, less than 10 mm in diameter, is differentiated-type adenocarcinoma (D.Ca), the incidence of D.Ca and that of undifferentiated-type adenocarcinoma (UD.Ca) is almost the same in all early gastric cancers. Histologic conversion from D.Ca to UD.Ca has been speculated, however, a detailed examination of this phenomenon has not yet been performed. Three-hundred and 51 early gastric cancers (D.Ca, 150 (42.7%) lesions; UD.Ca, 93 (26.4%) lesions; and mixed differentiated and undifferentiated type (D&UD.Ca), 108 (30.8%) lesions; tumor size less than 10 mm in diameter; 64 lesions, more than 10 mm, 287 lesions) were examined histochemically with paradoxical concanavalin A type III and high-iron diamine-Alcian blue (pH 2.5), and immunohistochemically with antigastric mucin antibody. The associations between tumor size, tumor differentiation and phenotypic expression of mucin were examined. Regardless of the tumor size, mucin phenotypic expression in the mucosal lesions examined was preserved. Of 47 cancers with a gastrointestinal mucin phenotype (GIM type) or a gastric mucin phenotype (GM type) measuring less than 10 mm, 35 (74.5%) consisted of D.Ca and 12 (25.5%) of both D&UD.Ca and UD.Ca, while of 224 GIM or GM type cancers measuring more than 10 mm, 64 (28.6%) consisted of D.Ca and 160 (71.4%) of both D&UD.Ca and UD.Ca. Differences between these two groups were statistically significant (P < 0.001). Of 15 cancers with an intestinal mucin phenotype (IM type) measuring less than 10 mm, 12 (80.0%) consisted of D.Ca and three (20.0%) of both D&UD.Ca and UD.Ca, and of 50 IM type cancers measuring more than 10 mm, 35 (70.0%) consisted of D.Ca and 15 (30.0%) of both D&UD.Ca and UD.Ca. Differences between these two groups were not statistically significant. These findings suggest that small D.Ca showing gastric mucin expression may transform into UD.Ca during the progression of early gastric cancer.

Topics: Adenocarcinoma; Alcian Blue; Concanavalin A; Gastric Mucins; Horseradish Peroxidase; Humans; Immunohistochemistry; Phenotype; Stomach Neoplasms

Signet ring cell carcinoma is a poorly differentiated adenocarcinoma in which the tumour cells invade singly or in small groups. Early stages of the disease can be missed easily when using regular haematoxylin and eosin staining. This is a report of a case in which routine screening of gastric biopsies with the Genta stain was responsible for rapid identification of signet ring carcinoma. The patient, a 29 year old woman, had a large portion of the antrum excised surgically for signet ring cell gastric carcinoma. Follow up endoscopy six years later showed no evidence of tumour. Twenty six large cup biopsies were obtained and a single focus of signet ring tumour cells infiltrating the surface mucosa in single files was seen. The diagnosis was missed on haematoxylin and eosin stain by three senior pathologists but owing to the Alcian blue component of the Genta stain the tumour cells were recognised easily. Thus, the Genta stain not only facilitates detection of Helicobacter pylori but also allows for simultaneous visualisation of gastric morphology as well as signet ring carcinoma that can be missed with conventional stains.

Topics: Adult; Alcian Blue; Carcinoma, Signet Ring Cell; Coloring Agents; Female; Helicobacter Infections; Helicobacter pylori; Humans; Stomach Neoplasms

Thirty cases of gastric cancer were studied. Slides were stained with PAS Alcian Blue. The staining characteristics of the mucin were correlated with gross characteristics of the tumours and histological types. Due to the few cases studied, there was no observed statistical significance between the various mucin staining characteristics with the histological type, sex site of tumour and ethnicity. In 84% of cases the tumour cells secreted either neutral or mixed mucins. Acid mucins were demonstrated in 5 cases only. Neutral mucin is normally secreted by gastric epithelium and neck cells of gastric glands. The observation in this study suggests that those tumours which secrete neutral and mixed mucin probably arise from gastric epithelium, neck cells of gastric glands or colonic metaplasia. In those cases where the tumour produces acid mucin it is possible the tumour arose from areas of intestinal metaplasia.

Topics: Adolescent; Adult; Alcian Blue; Carcinoma; Coloring Agents; Female; Humans; Male; Mucins; Stomach Neoplasms; Uganda

Mucins are produced by both benign and malignant gastric epithelium. In general, mucins can be classified into neutral and acidic mucins. The latter are of 2 major types, sulphated (sulphomucins) and carboxylated (sialomucins). A retrospective study was initiated at the Department of Pathology, University Hospital, Kuala Lumpur to histochemically study the mucin profiles of cases of intestinal (IGC) and diffuse (DGC) types of gastric carcinoma in Malaysian patients to determine whether a significant change of mucin type occurs in the event of malignant transformation. 42 IGC and 37 DGC were subjected to alcian blue-periodic acid Schiff and high iron diamine-alcian blue histochemical staining. In addition, 18 cases of gastrectomies performed for benign lesions in the stomach served as normal controls. The number of cases of IGC and DGC which exhibited sulphomucin production was significantly increased (p < 0.001) compared to normal controls. Also, the number of cases of DGC which produced neutral mucin were significantly less (p < 0.05) than the control group. However, there was no significant difference between the number of IGC and DGC cases which demonstrated sialomucin production and normal controls. It appears that while not pathognomonic, a lack of neutral mucin production should alert the pathologist to the possibility of a gastric malignancy, in particular DGC. The likelihood of a malignant lesion would be further supported if there is an increased sulphomucin production.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Alcian Blue; Cell Transformation, Neoplastic; Coloring Agents; Female; Gastric Mucosa; Humans; Male; Middle Aged; Mucins; Periodic Acid-Schiff Reaction; Retrospective Studies; Stomach; Stomach Neoplasms

Signet-ring-cell carcinomas were induced in the stomach of 12 beagle dogs by p.o. administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG), and the morphology and modes of cell proliferation in an incipient stage of cancer growth were studied with bromodeoxyuridine (BrdUrd) incorporation. From 5 to 27 months after the completion of 8 months' carcinogen treatment, minute carcinomas were found in the stomachs of 9 dogs. Before sacrifice, the dogs were given a single or repeated i.v. injections of BrdUrd for 1-3 days. Minute signet-ring-cell carcinomas were found to form a layered structure, in which the cancer cells proliferated in the lamina propria at the gland-neck level and differentiated to postmitotic signet-ring cells at the upper and lower levels of the mucosa. From repeated injections of BrdUrd, the time required for all the proliferative cells to be labelled with BrdUrd (reflecting the maximum cell-cycle time) was estimated to be 1.7 days for the normal glands, and 2.7 days for minute signet-ring-cell carcinomas. From the labelling index with BrdUrd as well as from the morphology, earliest carcinomas were identified in the single gland. There remained atrophic normal epithelium commonly in the single-gland lesions. Proliferative atypical cells appeared to be shed into the stroma passively through the atrophy and subsequent collapse of the gland rather than through active invasion. This may be a reason why cancer cells in minute signet-ring cell carcinomas preserved the normal pattern of cell renewal movement to form the layered structure.

Topics: Adenocarcinoma, Mucinous; Alcian Blue; Animals; Bromodeoxyuridine; Cell Division; Dogs; Gastric Mucosa; Immunoenzyme Techniques; Methylnitronitrosoguanidine; Precancerous Conditions; Stomach Neoplasms

Topics: Adenocarcinoma; Alcian Blue; Breast Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cytodiagnosis; Female; Humans; Lung Neoplasms; Ovarian Neoplasms; Periodic Acid-Schiff Reaction; Staining and Labeling; Stomach Neoplasms

Five cases of primary mucinous adenocarcinomas of the lung with signet-ring cells were studied with regard to clinical, pathologic, and prognostic implications and compared with the signet-ring cell adenocarcinomas of extrapulmonary sites. The patients ranged in age from 55 to 74 years, with a mean age of 67.8 years. There were three men and two women. Histologically, three cases were usual adenocarcinomas and two were bronchioloalveolar carcinomas. The percentage of signet-ring cells ranged from 10% to 50%, with a mean of 22% and a median of 20%. Therapy included lobectomy, radiation, and chemotherapy. Three of five patients died of their disease within 9 months and two patients showed no evidence of disease 5 months after presentation. Routine histology showed no significant differences between the signet-ring cells of any of the tumors; however, by special histochemistry, tumors originating from lung, stomach, and colon showed a more intense reaction with alcian blue stain than tumors from nose, breast, or bladder. Contrary to a previous report, we found no increase in sulfated acid mucins in these five cases of lung tumor. We also were unable to demonstrate a qualitative or quantitative difference between mucopolysaccharides produced by lung, stomach, or colon tumors. Although rare, mucinous adenocarcinoma of the lung with signet-ring cells can exist as a primary tumor.

Topics: Adenocarcinoma, Mucinous; Aged; Alcian Blue; Colonic Neoplasms; Female; Histocytochemistry; Humans; Lung Neoplasms; Male; Middle Aged; Mucins; Periodic Acid-Schiff Reaction; Staining and Labeling; Stomach Neoplasms

A case is described in which both a moderately elevated villous adenoma associated with adenocarcinoma at the posterior wall and an independent gastric carcinoma at the anterior wall were present. These two lesions were surrounded by the mucosa of incomplete intestinal metaplasia. Consecutive sections of the villous adenoma associated focally with carcinoma and the independent cancer were stained by the periodic acid-Schiff (PAS), pH 2.5 alcian blue (A1-B1), high iron diamine pH 2.5 alcian blue (HID-AB) and carcinoembryonic antigen peroxidase-antiperoxidase (CEA-PAP) methods. Villous adenoma was weakly positive in the PAS stain but negative in A1-B1 and HID stains, showing that it did not produce mucin. On the other hand, the intestinal metaplasia and cancerous lesions were positive in PAS, A1-B1 and HID stains, indicating production of the intestinal type of mucin. The villous adenoma accompanied by malignant changes was positive by the CEA-PAP method. This result shows the biological property of villous adenoma that they can easily change into malignancy. These three lesions in our case are considered to have originated independently from the primordial cells and to have developed the differences in mucin production in the process of cell development.

Topics: Adenocarcinoma; Adenoma; Aged; Alcian Blue; Carcinoembryonic Antigen; Female; Gastric Mucosa; Histocytochemistry; Humans; Metaplasia; Mucins; Neoplasms, Multiple Primary; Periodic Acid-Schiff Reaction; Stomach Neoplasms

Topics: Alcian Blue; Diamines; Female; Gastric Mucosa; Gastritis, Atrophic; Histocytochemistry; Humans; Intestines; Iron; Male; Metaplasia; Stomach Neoplasms

Topics: Alcian Blue; Gastric Mucins; Humans; Stomach Neoplasms

The occurrence of intestinal metaplasia with colonic-type sulphomucins: (abbreviated: s-IM or s-positive IM) in the gastric mucosa was studied in 125 patients with gastric carcinoma (GCA), 62 patients with pernicious anemia (PA), 301 and 183 first-degree relatives of GCA and PA patients, 406 outpatients and in 358 controls matched from a large population sample. The sulphomucins (s-mucins) were demonstrated histochemically in endoscopic biopsy specimens by using high iron diamine and Alcian blue (pH 1) methods. The prevalence of s-IM, especially the strongly s-positive IM, was significantly higher in GCA patients than in other series or controls of the same age group. Further, s-IM was significantly more common in PA patients and its prevalence higher in GCA relatives and outpatients than in other series or controls. The occurrence of s-IM was also age-dependent and dependent on the extent of IM. It was suggested that the occurrence of s-IM can be used as a sign of lesions that are more closely associated with GCA than IM is in general.

Topics: Adult; Age Factors; Aged; Alcian Blue; Anemia, Pernicious; Diamines; Female; Gastric Mucosa; Humans; Intestines; Male; Metaplasia; Middle Aged; Mucins; Sex Factors; Staining and Labeling; Stomach Neoplasms

An Alcian blue staining, perchloric acid-soluble, antigenic acidic mucosubstance (GOA) was purified from human gastric signet ring cell carcinoma with DEAE-cellulose chromatography, Seqhadex G-200 and preparative polycrylamide gel electrophoresis. Specific antisera were raised which reacted in indirect immunoenzyme histology with normal goblet cells of the small and large intestine and with goblet cells of intestinalized gastric mucosa. In surgical resection specimens of the stomach (n = 100) and of the colon (n = 19) 3 gastric signet ring cell carcinomas and 3 colonic colloidal adenocarcinomas stained for GOA, demonstrating an immunochemical relationship with normal intestinal goblet cells.

Topics: Adenocarcinoma, Mucinous; Alcian Blue; Antigens, Neoplasm; Colonic Neoplasms; Humans; Stomach Neoplasms