Abstract
BackgroundAtypical multinucleated stromal giant cells (MSGCs) are occasionally encountered in the esophagogastric mucosa. This study aims to investigate the origin and clinical association of MSGCs in the upper gastrointestinal tract.MethodsThree hundred sixty-one contiguous biopsies and 1 resection specimen from the stomach and gastroesophageal junction (GEJ) were identified from archives for morphologic and immunohistochemical studies.ResultsMSGCs were identified in 22 cases (6%: 7 gastric, 15 GEJ). Patients’ average age was 53 years. There was no sex predilection. 77% cases had only 1 or 2 MSGCs per 10 high power fields. MSGCs were located in the lamina propria of the gastric or GEJ mucosa, with an accentuation in the subepithelial zone. The median number of nuclei in a MSGC was 5 (ranging from 3 to 16). The nuclei were touching/overlapping, often arranged into “wreath”, “caterpillar”, or “morula” configurations. MSGCs expressed smooth muscle actin, desmin, while negative for cytokeratin AE1/3, CD68, S100, chromogranin, and CD117. The most common clinical history was epigastric pain, gastroesophageal reflux, and Barrett esophagus. The most common associated pathologic diagnoses included reactive (chemical) gastropathy (71% gastric biopsies) and gastroesophageal reflux (73% GEJ specimens).ConclusionsMSGCs in the esophagogastric mucosa show smooth muscle/myofibroblast differentiation by immunohistochemistry and likely represent a reactive/reparative stromal reaction associated with gastroesophageal reflux and reactive (chemical) gastropathy.
Highlights
Reactive/reparative changes of the gastrointestinal tract are commonly observed in the daily practice of surgical pathology, secondary to infection, inflammation, foreign body, and others
While multinucleated stromal giant cells (MSGCs) have been described previously in the lower gastrointestinal tract [1,2,3, 6], they have not been characterized in the upper gastrointestinal tract, to the best of our knowledge
Our goal is to identify the origin and significance of MSGCs in the esophagogastric mucosa, by Sachak et al Diagnostic Pathology (2019) 14:83 histomorphology and immunohistochemistry
Summary
Reactive/reparative changes of the gastrointestinal tract are commonly observed in the daily practice of surgical pathology, secondary to infection, inflammation, foreign body, and others. Benign multinucleated stromal giant cells are well known to exist at various sites, most commonly in the bladder, lower female genital tract, skin, anus, nose, breast, and testis [1,2,3,4,5,6,7,8,9,10]. While multinucleated stromal giant cells (MSGCs) have been described previously in the lower gastrointestinal tract [1,2,3, 6], they have not been characterized in the upper gastrointestinal tract, to the best of our knowledge. This study aims to investigate the origin and clinical association of MSGCs in the upper gastrointestinal tract
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