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Int J Clin Exp Pathol 2012;5(1):52-57

Original Article
Pathologic observations of the duodenum in 615 consecutive duodenal specimens in a
single Japanese hospital: II. Malignant lesions

Tadashi Terada

Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Received December 6, 2011; accepted December 14, 2011; Epub January 1, 2012; published January 15, 2012

Abstract: The author investigated histopathology of 615 consecutive duodenal specimens in our pathology laboratory in Japan. A computer
review of the duodenal specimens was done. In cases of malignancy, histological slides were reviewed. The duodenal specimens were
composed of 567 benign lesions (92%) and 48 malignant lesions (8%). The 48 malignant lesions were composed of 20 cases (42%) of
primary adenocarcinoma, 10 cases (21%) of primary adenocarcinoma of ampulla Vater, 4 cases (8%) of primary squamous cell carcinoma, 1
(2%) cases of primary spindle cell carcinoma, 4 (8%) cases of carcinoid tumors, 1 (2%) case of malignant lymphoma, and 8 cases (17%) of
secondary carcinoma from the pancreatic carcinoma or bile duct carcinoma. The primary adenocarcinoma (n=20) was composed of well
differentiated adenocarcinoma (n=9), papillary adenocarcinoma (n=1), moderately differentiated adenocarcinoma (n=6), and poorly
differentiated adenocarcinoma (n=4). The primary adenocarcinoma of the ampulla of Vater (n=10) was composed of well differentiated
adenocarcinoma (n=7) and moderately differentiated adenocarcinoma (n=3). The primary squamous cell carcinoma (n=4) showed proliferation
of malignant squamous cells with keratinization and intercellular bridges. The spindle cell carcinoma (n=1) consisted of only malignant spindle
cells immunohistochemistry positive for various cytokeratins and vimentin. The carcinoid tumor (n=4) was typical carcinoid and showed
organoid, trabecular, and ribbon-like arrangements. The carcinoid tumor was immunohistochemically positive for neuroendocrine markers
such as CD56, neuron-specific enolase and synaptophysin. The malignant lymphoma (n=1) was diffuse large B-cell lymphoma
immunohistochemically positive for CD10, CD20, and CD79α. The secondary carcinoma (n=8) was adenocarcinoma invaded from the
pancreatic adenocarcinoma (n=6) and extrahepatic bile duct adenocarcinoma (n=2)  (IJCEP1110011).

Keywords: duodenum, malignant lesions, pathology, consecutive duodenal specimens

Address all correspondence to:
Tadashi Terada, M.D., Ph.D.
Department of Pathology
Shizuoka City Shimizu Hospital
Miyakami 1231 Shimizu-Ku
Shizuoka 424-8636, Japan.
Tel: 81-54-336-1111, Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp