Abstract
Helicobacter pylori (HP) has been associated with neuroendocrine tumors of the stomach and duodenum. Gastric enterochromaffin-like (ECL) cell tumors and duodenal gastrinomas have also been associated with HP gastritis in separate series but have not been reported together. With other possible causes excluded, we present a patient with HP-associated atrophy of the oxyntic mucosa that ultimately resulted in stimulation and reactive hyperplasia of gastrin-producing cells in both the antrum and proximal duodenum, the latter progressing to formation of a gastrin-producing cell nodule (gastrinoma). Both of these sources of gastrin resulted in ECL hyperplasia in the atrophied oxyntic mucosa with progression to microcarcinoids and well-differentiated neuroendocrine tumors, along with hypertrophy of residual proximal gastric parietal cells. As atrophy tends to spread from the antrum proximally, residual oxyntic mucosa was still infected with HP and offers 1 explanation for the apparent paradox of atrophic gastritis with ECL hyperplasia and neoplasia in the distal oxyntic mucosa, with proximal oxyntic mucosa showing mild hypertrophic changes in a background of typical HP gastritis.
References
Oct 17, 1992·Lancet·S F MossJ Calam
Feb 1, 1990·Histopathology·E A SankeyA P Dhillon
May 1, 1990·Gut·J T SmithD J Evans
Dec 16, 1989·BMJ : British Medical Journal·S LeviJ Calam
May 27, 1989·Lancet·S LeviJ Calam
Oct 1, 1993·Scandinavian Journal of Gastroenterology·D M QueirozC A Oliveira
Nov 1, 1996·Gastroenterology·R M GentaJ L Burchette
May 7, 1998·Alimentary Pharmacology & Therapeutics·M StolteE Seifert
Aug 28, 1998·Gastroenterology·T WatanabeM Nakao
Mar 26, 2002·Digestive Diseases and Sciences·Yuichi SatoD H Van Thiel
Mar 29, 2002·Cancer·Hala M T El-ZimaityTsutomu Katsuyama
Dec 18, 2002·Helicobacter·Jiro KagawaToshio Fujioka
Aug 12, 2004·Journal of Gastroenterology and Hepatology·Chiao-Hsiung ChuangWei-Jen Yao
May 12, 2005·Gastroenterology·Martin AnlaufGünter Klöppel
Aug 30, 2005·Journal of Clinical Pathology·Y LiuF J W Ten Kate
Nov 17, 2006·Medicine·Marc J BernaRobert T Jensen
Nov 24, 2006·The American Journal of Surgical Pathology·Shakil H MerchantMitual B Amin
Nov 7, 2007·Wiener klinische Wochenschrift·Günter Klöppel, Martin Anlauf
Jul 16, 2010·The American Journal of Surgical Pathology·Robert Maximilian Genta, Richard H Lash
Citations
Jan 15, 2014·World Journal of Gastroenterology : WJG·Ting-Ting LiBen-Yan Wu
Jun 2, 2015·Archives of Pathology & Laboratory Medicine·Andrea Grin, Catherine J Streutker
Aug 8, 2013·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Shou-Jiang TangFeriyl Bhaijee
Dec 12, 2018·Pancreas·William C ChenMichelle Kang Kim
Jul 30, 2019·Khirurgiia·A V AlekberzadeE D Litovchenko
Jan 11, 2020·The Journal of Clinical Endocrinology and Metabolism·Ryan EndallJohn Burgess
Jul 25, 2020·BMC Gastroenterology·A MalczewskaB Kos-Kudla
Aug 30, 2016·World Journal of Gastroenterology : WJG·Yuichi SatoShuji Terai
Sep 27, 2018·Virchows Archiv : an International Journal of Pathology·Hala El-ZimaityRobert Riddell