Gut-associated lymphoid tissue or so-called “dome” carcinoma of the colon: Review
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摘要
AIM To present a comprehensive review of the etiology, clinical features, macroscopic and pathological findings, and clinical significance of Gut-associated lymphoid tissue or "dome" carcinoma of the colon.METHODS The English language medical literature on gut-or gastrointestinal-associated lymphoid tissue(GALT) or "dome" carcinoma of the colon was searched and appraised.RESULTS GALT/dome-type carcinomas of the colon are thought to arise from the M-cells of the lymphoglandular complex of the intestine. They are typically asymptomatic and have a characteristic endoscopic plaque-or "dome"-like appearance. Although the histology of GALT/dome-type carcinomas displays some variability, they are characterized by submucosal localization, a prominent lymphoid infiltrate with germinal center formation, tumor-infiltrating lymphocytes, absence of desmoplasia, and dilated glands lined by columnar epithelial cells with bland nuclear features and cytoplasmic eosinophilia. None of the patients reported in the literature with follow-up have developed metastatic disease or local recurrence.CONCLUSION Increased awareness amongst histopathologists of this variant of colorectal adenocarcinoma is likely to lead to the recognition of more cases.
AIM To present a comprehensive review of the etiology, clinical features, macroscopic and pathological findings, and clinical significance of Gut-associated lymphoid tissue or "dome" carcinoma of the colon.METHODS The English language medical literature on gut-or gastrointestinal-associated lymphoid tissue(GALT) or "dome" carcinoma of the colon was searched and appraised.RESULTS GALT/dome-type carcinomas of the colon are thought to arise from the M-cells of the lymphoglandular complex of the intestine. They are typically asymptomatic and have a characteristic endoscopic plaque-or "dome"-like appearance. Although the histology of GALT/dome-type carcinomas displays some variability, they are characterized by submucosal localization, a prominent lymphoid infiltrate with germinal center formation, tumor-infiltrating lymphocytes, absence of desmoplasia, and dilated glands lined by columnar epithelial cells with bland nuclear features and cytoplasmic eosinophilia. None of the patients reported in the literature with follow-up have developed metastatic disease or local recurrence.CONCLUSION Increased awareness amongst histopathologists of this variant of colorectal adenocarcinoma is likely to lead to the recognition of more cases.
AIM To present a comprehensive review of the etiology, clinical features, macroscopic and pathological findings, and clinical significance of Gut-associated lymphoid tissue or "dome" carcinoma of the colon.METHODS The English language medical literature on gut-or gastrointestinal-associated lymphoid tissue(GALT) or "dome" carcinoma of the colon was searched and appraised.RESULTS GALT/dome-type carcinomas of the colon are thought to arise from the M-cells of the lymphoglandular complex of the intestine. They are typically asymptomatic and have a characteristic endoscopic plaque-or "dome"-like appearance. Although the histology of GALT/dome-type carcinomas displays some variability, they are characterized by submucosal localization, a prominent lymphoid infiltrate with germinal center formation, tumor-infiltrating lymphocytes, absence of desmoplasia, and dilated glands lined by columnar epithelial cells with bland nuclear features and cytoplasmic eosinophilia. None of the patients reported in the literature with follow-up have developed metastatic disease or local recurrence.CONCLUSION Increased awareness amongst histopathologists of this variant of colorectal adenocarcinoma is likely to lead to the recognition of more cases.
引文
1 Kannuna H,Rubio CA,Silverio PC,Girardin M,Goossens N,Rubbia-Brandt L,Puppa G.DOME/GALT type adenocarcimoma of the colon:a case report,literature review and a unified phenotypic categorization.Diagn Pathol 2015;10:92[PMID:26156870 DOI:10.1186/s13000-015-0305-1]
2 Rubio CA,Lindh C,Bj?rk J,T?rnblom H,Befrits R.Protruding and non-protruding colon carcinomas originating in gut-associated lymphoid tissue.Anticancer Res 2010;30:3019-3022[PMID:20683049]
3 Rubio CA,Talbot I.Lymphoid-associated neoplasia in herniated colonic mucosa.Histopathology2002;40:577-579[PMID:12047774 DOI:10.1046/j.1365-2559.2002.t01-2-01294.x]
4 Jass JR,Constable L,Sutherland R,Winterford C,Walsh MD,Young J,Leggett BA.Adenocarcinoma of colon differentiating as dome epithelium of gut-associated lymphoid tissue.Histopathology 2000;36:116-120[PMID:10672055 DOI:10.1046/j.1365-2559.2000.00864.x]
5 Bhalla DK,Owen RL.Cell renewal and migration in lymphoid follicles of Peyer’s patches and cecum--an autoradiographic study in mice.Gastroenterology 1982;82:232-242[PMID:7054025]
6 Neutra MR.Current concepts in mucosal immunity.V Role of M cells in transepithelial transport of antigens and pathogens to the mucosal immune system.Am J Physiol 1998;274:G785-G791[PMID:9612256]
7 Gebert A,Rothk?tter HJ,Pabst R.M cells in Peyer’s patches of the intestine.Int Rev Cytol 1996;167:91-159[PMID:8768493 DOI:10.1016/S0074-7696(08)61346-7]
8 Dukes CE.The surgical pathology of ulcerative colitis.Ann R Coll Surg Engl 1954;14:389-400[PMID:13159102]
9 Hultén L,Kewenter J,Ahrén C.Precancer and carcinoma in chronic ulcerative colitis.Ahistopathological and clinical investigation.Scand J Gastroenterol 1972;7:663-669[PMID:4344844DOI:10.3109/00365527209180974]
10 Dyson JL.Herniation of mucosal epithelium into the submucosa in chronic ulcerative colitis.JClin Pathol 1975;28:189-194[PMID:1123445 DOI:10.1136/jcp.28.3.189]
11 Oohara T,Ogino A,Tohma H.Microscopic adenoma in nonpolyposis coli:incidence and relation to basal cells and lymphoid follicles.Dis Colon Rectum 1981;24:120-126[PMID:7215074DOI:10.1007/BF02604300]
12 Cameron IL,Garza J,Hardman WE.Distribution of lymphoid nodules,aberrant crypt foci and tumours in the colon of carcinogen-treated rats.Br J Cancer 1996;73:893-898[PMID:8611402DOI:10.1038/bjc.1996.159]
13 Hardman WE,Cameron IL.Colonic crypts located over lymphoid nodules of 1,2-dimethylhydrazine-treated rats are hyperplastic and at high risk of forming adenocarcinomas.Carcinogenesis 1994;15:2353-2361[PMID:7955077 DOI:10.1093/carcin/15.10.2353]
14 Rubio CA.Ectopic colonic mucosa in ulcerative colitis and in Crohn’s disease of the colon.Dis Colon Rectum 1984;27:182-186[PMID:6697844 DOI:10.1007/BF02555670]
15 De Petris G,Lev R,Quirk DM,Ferbend PR,Butmarc JR,Elenitoba-Johnson K.Lymphoepithelioma-like carcinoma of the colon in a patient with hereditary nonpolyposis colorectal cancer.Arch Pathol Lab Med 1999;123:720-724[PMID:10420231 DOI:10.1043/0003-9985(1999)123<0720:LLCOTC>2.0.CO;2]
16 Rubio CA,Befrits R,Ericsson J.Carcinoma in gut-associated lymphoid tissue in ulcerative colitis:Case report and review of literature.World J Gastrointest Endosc 2013;5:293-296[PMID:23772267 DOI:10.4253/wjge.v5.i6.293]
17 Rubio CA,DE Petris G,Puppa G.Gut-associated Lymphoid Tissue(GALT)Carcinoma in Ulcerative Colitis.Anticancer Res 2018;38:919-921[PMID:29374721 DOI:10.21873/anticanres.12303]
18 Puppa G,Molaro M.Dome-type:a distinctive variant of colonic adenocarcinoma.Case Rep Pathol2012;2012:284064[PMID:23213588 DOI:10.1155/2012/284064]
19 Yamada M,Sekine S,Matsuda T.Dome-type carcinoma of the colon masquerading a submucosal tumor.Clin Gastroenterol Hepatol 2013;11:A30[PMID:23200981 DOI:10.1016/j.cgh.2012.11.009]
20 Winterford CM,Walsh MD,Leggett BA,Jass JR.Ultrastructural localization of epithelial mucin core proteins in colorectal tissues.J Histochem Cytochem 1999;47:1063-1074[PMID:10424891DOI:10.1177/002215549904700811]
21 Hou YY,Tan YS,Xu JF,Wang XN,Lu SH,Ji Y,Wang J,Zhu XZ.Schwannoma of the gastrointestinal tract:a clinicopathological,immunohistochemical and ultrastructural study of 33cases.Histopathology 2006;48:536-545[PMID:16623779 DOI:10.1111/j.1365-2559.2006.02370.x]
22 Marginean F,Rakha EA,Ho BC,Ellis IO,Lee AH.Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast.Mod Pathol 2010;23:1357-1363[PMID:20581807 DOI:10.1038/modpathol.2010.123]
23 Chetty R.Gastrointestinal cancers accompanied by a dense lymphoid component:an overview with special reference to gastric and colonic medullary and lymphoepithelioma-like carcinomas.J Clin Pathol 2012;65:1062-1065[PMID:22918886 DOI:10.1136/jclinpath-2012-201067]
24 Asmussen L,Pachler J,Holck S.Colorectal carcinoma with dome-like phenotype:an underrecognised subset of colorectal carcinoma?J Clin Pathol 2008;61:482-486[PMID:17827397 DOI:10.1136/jcp.2007.047621]
25 Clouston AD,Clouston DR,Jass JR.Adenocarcinoma of colon differentiating as dome epithelium of gut-associated lymphoid tissue.Histopathology 2000;37:567[PMID:11122441 DOI:10.1046/j.1365-2559.2000.01018-3.x]
26 Stewart CJ,Hillery S,Newman N,Platell C,Ryan G.Dome-type carcinoma of the colon.Histopathology 2008;53:231-234[PMID:18518901 DOI:10.1111/j.1365-2559.2008.03061.x]
27 Coyne JD.Dome-type colorectal carcinoma:a case report and review of the literature.Colorectal Dis 2012;14:e360-e362[PMID:21883810 DOI:10.1111/j.1463-1318.2011.02795.x]
28 O’Leary AD,Sweeney EC.Lymphoglandular complexes of the colon:structure and distribution.Histopathology 1986;10:267-283[PMID:3486153 DOI:10.1111/j.1365-2559.1986.tb02481.x]
29 Kealy WF.Colonic lymphoid-glandular complex(microbursa):nature and morphology.J Clin Pathol 1976;29:241-244[PMID:1270606 DOI:10.1136/jcp.29.3.241]
30 Kuper CF.Histopathology of mucosa-associated lymphoid tissue.Toxicol Pathol 2006;34:609-615[PMID:17067946 DOI:10.1080/01926230600867735]
31 Martin MS,Hammann A,Martin F.Gut-associated lymphoid tissue and 1,2-dimethylhydrazine intestinal tumors in the rat:an histological and immunoenzymatic study.Int J Cancer 1986;38:75-80[PMID:3522439 DOI:10.1002/ijc.2910380113]
32 Lloyd J,Darzi A,Teare J,Goldin RD.A solitary benign lymphoid polyp of the rectum in a 51year old woman.J Clin Pathol 1997;50:1034-1035[PMID:9516890 DOI:10.1136/jcp.50.12.1034]
33 Arida M,Barnes EL,Hunt JL.Molecular assessment of allelic loss in Warthin tumors.Mod Pathol2005;18:964-968[PMID:15861216 DOI:10.1038/modpathol.3800379]
34 A R R,Rehani S,Bishen KA,Sagari S.Warthin’s Tumour:A Case Report and Review on Pathogenesis and its Histological Subtypes.J Clin Diagn Res 2014;8:ZD37-ZD40[PMID:25386545 DOI:10.7860/JCDR/2014/8503.4908]
35 Thompson AS,Bryant HC Jr.Histogenesis of papillary cystadenoma lymphomatosum(Warthin’s tumor)of the parotid salivary gland.Am J Pathol 1950;26:807-849[PMID:15432614]
36 Chapnik JS.The controversy of Warthin’s tumor.Laryngoscope 1983;93:695-716[PMID:6304434DOI:10.1288/00005537-198306000-00002]
37 Allegra SR.Warthin’s tumor:a hypersensitivity disease?Ultrastructural,light,and immunofluorescent study.Hum Pathol 1971;2:403-420[PMID:5118200 DOI:10.1016/S0046-8177(71)80007-2]
38 Warnock GR.Papillary cystadenoma lymphornatosurn(Warthin's tumour).In:Ellis GL,Auclair PL,Gnepp DR(Eds.),Surgical Pathology of the Salivary Glands,W.B.Saunders Company Ltd.Philadelphia 1991;187-201
39 Foulsham CK 2nd,Snyder GG 3rd,Carpenter RJ 3rd.Papillary cystadenoma lymphomatosum of the larynx.Otolaryngol Head Neck Surg 1981;89:960-964[PMID:6801598 DOI:10.1177/019459988108900616]
40 Martins C,Fonseca I,Roque L,Soares J.Cytogenetic characterisation of Warthin’s tumour.Oral Oncol 1997;33:344-347[PMID:9415334 DOI:10.1016/S1368-8375(97)00011-0]
41 Mark J,Dahlenfors R,Stenman G,Nordquist A.Chromosomal patterns in Warthin’s tumor.Asecond type of human benign salivary gland neoplasm.Cancer Genet Cytogenet 1990;46:35-39[PMID:2331681 DOI:10.1016/0165-4608(90)90006-V]
42 Bullerdiek J,Haubrich J,Meyer K,Bartnitzke S.Translocation t(11;19)(q21;p13.1)as the sole chromosome abnormality in a cystadenolymphoma(Warthin’s tumor)of the parotid gland.Cancer Genet Cytogenet 1988;35:129-132[PMID:3180001 DOI:10.1016/0165-4608(88)90131-8]
43 Honda K,Kashima K,Daa T,Yokoyama S,Nakayama I.Clonal analysis of the epithelial component of Warthin’s tumor.Hum Pathol 2000;31:1377-1380[PMID:11112212 DOI:10.1053/hupa.2000.19449]
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2 Rubio CA,Lindh C,Bj?rk J,T?rnblom H,Befrits R.Protruding and non-protruding colon carcinomas originating in gut-associated lymphoid tissue.Anticancer Res 2010;30:3019-3022[PMID:20683049]
3 Rubio CA,Talbot I.Lymphoid-associated neoplasia in herniated colonic mucosa.Histopathology2002;40:577-579[PMID:12047774 DOI:10.1046/j.1365-2559.2002.t01-2-01294.x]
4 Jass JR,Constable L,Sutherland R,Winterford C,Walsh MD,Young J,Leggett BA.Adenocarcinoma of colon differentiating as dome epithelium of gut-associated lymphoid tissue.Histopathology 2000;36:116-120[PMID:10672055 DOI:10.1046/j.1365-2559.2000.00864.x]
5 Bhalla DK,Owen RL.Cell renewal and migration in lymphoid follicles of Peyer’s patches and cecum--an autoradiographic study in mice.Gastroenterology 1982;82:232-242[PMID:7054025]
6 Neutra MR.Current concepts in mucosal immunity.V Role of M cells in transepithelial transport of antigens and pathogens to the mucosal immune system.Am J Physiol 1998;274:G785-G791[PMID:9612256]
7 Gebert A,Rothk?tter HJ,Pabst R.M cells in Peyer’s patches of the intestine.Int Rev Cytol 1996;167:91-159[PMID:8768493 DOI:10.1016/S0074-7696(08)61346-7]
8 Dukes CE.The surgical pathology of ulcerative colitis.Ann R Coll Surg Engl 1954;14:389-400[PMID:13159102]
9 Hultén L,Kewenter J,Ahrén C.Precancer and carcinoma in chronic ulcerative colitis.Ahistopathological and clinical investigation.Scand J Gastroenterol 1972;7:663-669[PMID:4344844DOI:10.3109/00365527209180974]
10 Dyson JL.Herniation of mucosal epithelium into the submucosa in chronic ulcerative colitis.JClin Pathol 1975;28:189-194[PMID:1123445 DOI:10.1136/jcp.28.3.189]
11 Oohara T,Ogino A,Tohma H.Microscopic adenoma in nonpolyposis coli:incidence and relation to basal cells and lymphoid follicles.Dis Colon Rectum 1981;24:120-126[PMID:7215074DOI:10.1007/BF02604300]
12 Cameron IL,Garza J,Hardman WE.Distribution of lymphoid nodules,aberrant crypt foci and tumours in the colon of carcinogen-treated rats.Br J Cancer 1996;73:893-898[PMID:8611402DOI:10.1038/bjc.1996.159]
13 Hardman WE,Cameron IL.Colonic crypts located over lymphoid nodules of 1,2-dimethylhydrazine-treated rats are hyperplastic and at high risk of forming adenocarcinomas.Carcinogenesis 1994;15:2353-2361[PMID:7955077 DOI:10.1093/carcin/15.10.2353]
14 Rubio CA.Ectopic colonic mucosa in ulcerative colitis and in Crohn’s disease of the colon.Dis Colon Rectum 1984;27:182-186[PMID:6697844 DOI:10.1007/BF02555670]
15 De Petris G,Lev R,Quirk DM,Ferbend PR,Butmarc JR,Elenitoba-Johnson K.Lymphoepithelioma-like carcinoma of the colon in a patient with hereditary nonpolyposis colorectal cancer.Arch Pathol Lab Med 1999;123:720-724[PMID:10420231 DOI:10.1043/0003-9985(1999)123<0720:LLCOTC>2.0.CO;2]
16 Rubio CA,Befrits R,Ericsson J.Carcinoma in gut-associated lymphoid tissue in ulcerative colitis:Case report and review of literature.World J Gastrointest Endosc 2013;5:293-296[PMID:23772267 DOI:10.4253/wjge.v5.i6.293]
17 Rubio CA,DE Petris G,Puppa G.Gut-associated Lymphoid Tissue(GALT)Carcinoma in Ulcerative Colitis.Anticancer Res 2018;38:919-921[PMID:29374721 DOI:10.21873/anticanres.12303]
18 Puppa G,Molaro M.Dome-type:a distinctive variant of colonic adenocarcinoma.Case Rep Pathol2012;2012:284064[PMID:23213588 DOI:10.1155/2012/284064]
19 Yamada M,Sekine S,Matsuda T.Dome-type carcinoma of the colon masquerading a submucosal tumor.Clin Gastroenterol Hepatol 2013;11:A30[PMID:23200981 DOI:10.1016/j.cgh.2012.11.009]
20 Winterford CM,Walsh MD,Leggett BA,Jass JR.Ultrastructural localization of epithelial mucin core proteins in colorectal tissues.J Histochem Cytochem 1999;47:1063-1074[PMID:10424891DOI:10.1177/002215549904700811]
21 Hou YY,Tan YS,Xu JF,Wang XN,Lu SH,Ji Y,Wang J,Zhu XZ.Schwannoma of the gastrointestinal tract:a clinicopathological,immunohistochemical and ultrastructural study of 33cases.Histopathology 2006;48:536-545[PMID:16623779 DOI:10.1111/j.1365-2559.2006.02370.x]
22 Marginean F,Rakha EA,Ho BC,Ellis IO,Lee AH.Histological features of medullary carcinoma and prognosis in triple-negative basal-like carcinomas of the breast.Mod Pathol 2010;23:1357-1363[PMID:20581807 DOI:10.1038/modpathol.2010.123]
23 Chetty R.Gastrointestinal cancers accompanied by a dense lymphoid component:an overview with special reference to gastric and colonic medullary and lymphoepithelioma-like carcinomas.J Clin Pathol 2012;65:1062-1065[PMID:22918886 DOI:10.1136/jclinpath-2012-201067]
24 Asmussen L,Pachler J,Holck S.Colorectal carcinoma with dome-like phenotype:an underrecognised subset of colorectal carcinoma?J Clin Pathol 2008;61:482-486[PMID:17827397 DOI:10.1136/jcp.2007.047621]
25 Clouston AD,Clouston DR,Jass JR.Adenocarcinoma of colon differentiating as dome epithelium of gut-associated lymphoid tissue.Histopathology 2000;37:567[PMID:11122441 DOI:10.1046/j.1365-2559.2000.01018-3.x]
26 Stewart CJ,Hillery S,Newman N,Platell C,Ryan G.Dome-type carcinoma of the colon.Histopathology 2008;53:231-234[PMID:18518901 DOI:10.1111/j.1365-2559.2008.03061.x]
27 Coyne JD.Dome-type colorectal carcinoma:a case report and review of the literature.Colorectal Dis 2012;14:e360-e362[PMID:21883810 DOI:10.1111/j.1463-1318.2011.02795.x]
28 O’Leary AD,Sweeney EC.Lymphoglandular complexes of the colon:structure and distribution.Histopathology 1986;10:267-283[PMID:3486153 DOI:10.1111/j.1365-2559.1986.tb02481.x]
29 Kealy WF.Colonic lymphoid-glandular complex(microbursa):nature and morphology.J Clin Pathol 1976;29:241-244[PMID:1270606 DOI:10.1136/jcp.29.3.241]
30 Kuper CF.Histopathology of mucosa-associated lymphoid tissue.Toxicol Pathol 2006;34:609-615[PMID:17067946 DOI:10.1080/01926230600867735]
31 Martin MS,Hammann A,Martin F.Gut-associated lymphoid tissue and 1,2-dimethylhydrazine intestinal tumors in the rat:an histological and immunoenzymatic study.Int J Cancer 1986;38:75-80[PMID:3522439 DOI:10.1002/ijc.2910380113]
32 Lloyd J,Darzi A,Teare J,Goldin RD.A solitary benign lymphoid polyp of the rectum in a 51year old woman.J Clin Pathol 1997;50:1034-1035[PMID:9516890 DOI:10.1136/jcp.50.12.1034]
33 Arida M,Barnes EL,Hunt JL.Molecular assessment of allelic loss in Warthin tumors.Mod Pathol2005;18:964-968[PMID:15861216 DOI:10.1038/modpathol.3800379]
34 A R R,Rehani S,Bishen KA,Sagari S.Warthin’s Tumour:A Case Report and Review on Pathogenesis and its Histological Subtypes.J Clin Diagn Res 2014;8:ZD37-ZD40[PMID:25386545 DOI:10.7860/JCDR/2014/8503.4908]
35 Thompson AS,Bryant HC Jr.Histogenesis of papillary cystadenoma lymphomatosum(Warthin’s tumor)of the parotid salivary gland.Am J Pathol 1950;26:807-849[PMID:15432614]
36 Chapnik JS.The controversy of Warthin’s tumor.Laryngoscope 1983;93:695-716[PMID:6304434DOI:10.1288/00005537-198306000-00002]
37 Allegra SR.Warthin’s tumor:a hypersensitivity disease?Ultrastructural,light,and immunofluorescent study.Hum Pathol 1971;2:403-420[PMID:5118200 DOI:10.1016/S0046-8177(71)80007-2]
38 Warnock GR.Papillary cystadenoma lymphornatosurn(Warthin's tumour).In:Ellis GL,Auclair PL,Gnepp DR(Eds.),Surgical Pathology of the Salivary Glands,W.B.Saunders Company Ltd.Philadelphia 1991;187-201
39 Foulsham CK 2nd,Snyder GG 3rd,Carpenter RJ 3rd.Papillary cystadenoma lymphomatosum of the larynx.Otolaryngol Head Neck Surg 1981;89:960-964[PMID:6801598 DOI:10.1177/019459988108900616]
40 Martins C,Fonseca I,Roque L,Soares J.Cytogenetic characterisation of Warthin’s tumour.Oral Oncol 1997;33:344-347[PMID:9415334 DOI:10.1016/S1368-8375(97)00011-0]
41 Mark J,Dahlenfors R,Stenman G,Nordquist A.Chromosomal patterns in Warthin’s tumor.Asecond type of human benign salivary gland neoplasm.Cancer Genet Cytogenet 1990;46:35-39[PMID:2331681 DOI:10.1016/0165-4608(90)90006-V]
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