| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Regular Articles |
From the Departments of Pathology,*
Oncology,¶
and Surgery,§
The Johns Hopkins University School of Medicine, Baltimore, Maryland;
the Department of Pathology,||
Academic Medical Center,
University of Amsterdam, Amsterdam, The Netherlands; the Department of
Laboratory Medicine and Pathobiology,
University of Toronto, Toronto, Canada; and the Department of
Pathology,
Wayne State University,
Detroit, Michigan
Medullary carcinomas of the pancreas are a recently described, histologically distinct subset of poorly differentiated adenocarcinomas that may have a unique pathogenesis and clinical course. To further evaluate these neoplasms, we studied genetic, pathological, and clinical features of 13 newly identified medullary carcinomas of the pancreas. Nine (69%) of these had wild-type K-ras genes, and one had microsatellite instability (MSI). This MSI medullary carcinoma, along with three previously reported MSI medullary carcinomas, were examined immunohistochemically for Mlh1 and Msh2 expression, and all four expressed Msh2 but did not express Mlh1. In contrast, all of the medullary carcinomas without MSI expressed both Msh2 and Mlh1. Remarkably, the MSI medullary carcinoma of the pancreas in the present series arose in a patient with a synchronous but histologically distinct cecal carcinoma that also had MSI and did not express Mlh1. The synchronous occurrence of two MSI carcinomas suggests an inherited basis for the development of these carcinomas. Indeed, the medullary phenotype, irrespective of MSI, was highly associated with a family history of cancer in first-degree relatives (P < 0.001). Finally, one medullary carcinoma with lymphoepithelioma-like features contained Epstein-Barr virus-encoded RNA-1 by in situ hybridization. Therefore, because of medullary carcinoma’s special genetic, immunohistochemical, and clinical features, recognition of the medullary variant of pancreatic adenocarcinoma is important. Only by classifying medullary carcinoma as special subset of adenocarcinoma can we hope to further elucidate its unique pathogenesis.
This article has been cited by other articles:
 |
|
 |
|
  C. Shi, A. P. Klein, M. Goggins, A. Maitra, M. Canto, S. Ali, R. Schulick, E. Palmisano, and R. H. Hruban Increased Prevalence of Precursor Lesions in Familial Pancreatic Cancer Patients Clin. Cancer Res., December 15, 2009; 15(24): 7737 - 7743. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Wang, K. A. Brune, K. Visvanathan, D. Laheru, J. Herman, C. Wolfgang, R. Schulick, J. L. Cameron, M. Goggins, R. H. Hruban, et al. Elevated Cancer Mortality in the Relatives of Patients with Pancreatic Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2009; 18(11): 2829 - 2834. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Kastrinos, B. Mukherjee, N. Tayob, F. Wang, J. Sparr, V. M. Raymond, P. Bandipalliam, E. M. Stoffel, S. B. Gruber, and S. Syngal Risk of Pancreatic Cancer in Families With Lynch Syndrome JAMA, October 28, 2009; 302(16): 1790 - 1795. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Blackford, G. Parmigiani, T. W. Kensler, C. Wolfgang, S. Jones, X. Zhang, D. W. Parsons, J. C.-H. Lin, R. J. Leary, J. R. Eshleman, et al. Genetic Mutations Associated with Cigarette Smoking in Pancreatic Cancer Cancer Res., April 15, 2009; 69(8): 3681 - 3688. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Koessler, M Z Oestergaard, H Song, J Tyrer, B Perkins, A M Dunning, D F Easton, and P D P Pharoah Common variants in mismatch repair genes and risk of colorectal cancer Gut, August 1, 2008; 57(8): 1097 - 1101. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Feldmann and A. Maitra Molecular Genetics of Pancreatic Ductal Adenocarcinomas and Recent Implications for Translational Efforts J. Mol. Diagn., March 1, 2008; 10(2): 111 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Bardeesy, K.-h. Cheng, J. H. Berger, G. C. Chu, J. Pahler, P. Olson, A. F. Hezel, J. Horner, G. Y. Lauwers, D. Hanahan, et al. Smad4 is dispensable for normal pancreas development yet critical in progression and tumor biology of pancreas cancer. Genes & Dev., November 15, 2006; 20(22): 3130 - 3146. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Hruban, N. V. Adsay, J. Albores-Saavedra, M. R. Anver, A. V. Biankin, G. P. Boivin, E. E. Furth, T. Furukawa, A. Klein, D. S. Klimstra, et al. Pathology of Genetically Engineered Mouse Models of Pancreatic Exocrine Cancer: Consensus Report and Recommendations Cancer Res., January 1, 2006; 66(1): 95 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Calhoun, J. B. Jones, R. Ashfaq, V. Adsay, S. J. Baker, V. Valentine, P. M. Hempen, W. Hilgers, C. J. Yeo, R. H. Hruban, et al. BRAF and FBXW7 (CDC4, FBW7, AGO, SEL10) Mutations in Distinct Subsets of Pancreatic Cancer: Potential Therapeutic Targets Am. J. Pathol., October 1, 2003; 163(4): 1255 - 1260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rashid, T. Ueki, Y.-T. Gao, P. S. Houlihan, C. Wallace, B.-S. Wang, M.-C. Shen, J. Deng, and A. W. Hsing K-ras Mutation, p53 Overexpression, and Microsatellite Instability in Biliary Tract Cancers: A Population-based Study in China Clin. Cancer Res., October 1, 2002; 8(10): 3156 - 3163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Nakata, Y. Qing Wang, M. Yashiro, N. Nishioka, H. Tanaka, M. Ohira, T. Ishikawa, H. Nishino, and K. Hirakawa Prognostic Value of Microsatellite Instability in Resectable Pancreatic Cancer Clin. Cancer Res., August 1, 2002; 8(8): 2536 - 2540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Abraham, T.-T. Wu, R. H. Hruban, J.-H. Lee, C. J. Yeo, K. Conlon, M. Brennan, J. L. Cameron, and D. S. Klimstra Genetic and Immunohistochemical Analysis of Pancreatic Acinar Cell Carcinoma : Frequent Allelic Loss on Chromosome 11p and Alterations in the APC/{beta}-Catenin Pathway Am. J. Pathol., March 1, 2002; 160(3): 953 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Iacobuzio-Donahue, B. Ryu, R. H. Hruban, and S. E. Kern Exploring the Host Desmoplastic Response to Pancreatic Carcinoma : Gene Expression of Stromal and Neoplastic Cells at the Site of Primary Invasion Am. J. Pathol., January 1, 2002; 160(1): 91 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Yamamoto, F. Itoh, H. Nakamura, H. Fukushima, S. Sasaki, M. Perucho, and K. Imai Genetic and Clinical Features of Human Pancreatic Ductal Adenocarcinomas with Widespread Microsatellite Instability Cancer Res., April 1, 2001; 61(7): 3139 - 3144. [Abstract] [Full Text]
|
|
|
|
|
|
A. C. Tersmette, G. M. Petersen, G. J. A. Offerhaus, F. C. Falatko, K. A. Brune, M. Goggins, E. Rozenblum, R. E. Wilentz, C. J. Yeo, J. L. Cameron, et al. Increased Risk of Incident Pancreatic Cancer Among First-degree Relatives of Patients with Familial Pancreatic Cancer Clin. Cancer Res., March 1, 2001; 7(3): 738 - 744. [Abstract] [Full Text]
|
|
|
|
|
|
J. Alexander, T. Watanabe, T.-T. Wu, A. Rashid, S. Li, and S. R. Hamilton Histopathological Identification of Colon Cancer with Microsatellite Instability Am. J. Pathol., February 1, 2001; 158(2): 527 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Montgomery, M. Goggins, S. Zhou, P. Argani, R. E. Wilentz, M. Kaushal, S. Booker, K. Romans, P. Bhargava, R. H. Hruban, et al. Nuclear Localization of Dpc4 (Madh4, Smad4) in Colorectal Carcinomas and Relation to Mismatch Repair/Transforming Growth Factor-{beta} Receptor Defects Am. J. Pathol., February 1, 2001; 158(2): 537 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Hruban, R. E. Wilentz, and S. E. Kern Genetic Progression in the Pancreatic Ducts Am. J. Pathol., June 1, 2000; 156(6): 1821 - 1825. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
