MEETING No. 21, JUNE 17th- 18th, ALBA, CUNEO

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 4

"DUODENAL POLYP"
G. CERA - Mondovì Hospital
(pict. by dr. Cera )

Clinical history: a 51y.o. woman with a history of pyrosis, stomach pain and frontal head ache, undergoes an esophagoduodenoscopy.
Multiple gastric biopsies are taken and a diagnosis of HP positive, active gastritis is done. In the second portion of the duodenum, away from the ampullar region, a whitish 5mm polyp is noted.
Microscopic description: sections of the polyp show a tubular adenoma with mild dysplasia and numerous Paneth cells (pict. 1) - (pict. 2) which have abundant Alcian PAS positive (pict. 3) - (pict. 4) - (pict. 5) and pH 2.5 Alcian negative cytoplasmic granules.
There are also numerous cells, which show strongly Alcian PAS positive and immunohistochemically Chromogranin positive granules (pict. 6).
The immunohistochemically stained section is then counterstained histochemically with PAS diastase (pict. 7) and shows clearly the two different kinds of cells in the polyp: Chromogranin-positive neuroendocrine cells and PAS positive Paneth cells.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7

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