Carcinoids and endocrine cell micronests of the minor and major duodenal papillae. Their incidence and characteristics

Cancer. 1992 Oct 1;70(7):1825-33. doi: 10.1002/1097-0142(19921001)70:7<1825::aid-cncr2820700703>3.0.co;2-w.

Abstract

Background: There have been no reports about the incidence and characteristics of carcinoids and endocrine cell micronests (ECM) of the minor and major duodenal papillae.

Methods and results: The minor and major duodenal papillae of 78 consecutive autopsy and 117 surgical specimens were examined histologically using mirror-image paraffin-embedded tissue samples. ECM were found frequently in these areas in hematoxylin and eosin-stained sections, and their aggregation patterns were classified into four types: nodular type (Type 1, 2 of 167 in the minor papilla and 1 of 145 in the major papilla), scattered type (Type 2, 39 of 167 and 6 of 145), orifice type (Type 3, 7 of 167 and 0 of 145), and islet-like type (Type 4, 14 of 145 and 0 of 145, respectively). Criteria of neoplastic or nonneoplastic ECM were defined tentatively by histologic and immunohistochemical analyses of the ECM. Type 4 was regarded to be atrophic or regenerating islets of Langerhans. Distinct carcinoids (Type 1), neoplastic ECM (39% of all Type 2 and 3), and nonneoplastic ECM (61% of all Type 2 and 3) were found in 1.2%, 9.0%, and 16.2% of 167 samples of the minor papilla and 0.7%, 1.4%, and 2.8% of 145 specimens of the major papilla, respectively. The endocrine cells composing the carcinoids and the ECM usually were immunoreactive for somatostatin and/or pancreatic polypeptide (PP). They were negative for S-100 beta.

Conclusion: In duodenal papillae, especially in the minor duodenal papilla, carcinoids and ECM seem to occur more frequently than generally thought, and predominantly consist of somatostatin and/or PP containing cells.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ampulla of Vater / cytology*
  • Ampulla of Vater / ultrastructure
  • Carcinoid Tumor / pathology*
  • Child
  • Child, Preschool
  • Common Bile Duct Neoplasms / pathology*
  • Endocrine Glands / cytology*
  • Endocrine Glands / ultrastructure
  • Female
  • Humans
  • Immunohistochemistry
  • Infant
  • Male
  • Middle Aged
  • Pancreatic Ducts / cytology*
  • Pancreatic Ducts / ultrastructure
  • Pancreatic Neoplasms / pathology*