Sporadic Cajal cell hyperplasia is common in resection specimens for distal oesophageal carcinoma : A retrospective review of 77 consecutive surgical resection specimens

• Published in: Virchows Archiv : an international journal of pathology Vol. 448; no. 3; pp. 288 - 294
• Main Authors: AGAIMY, Abbas, WÜNSCH, Peter H
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.03.2006; Springer Nature B.V
• Subjects: Adenocarcinoma - chemistry; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Aged, 80 and over; Barrett Esophagus - metabolism; Barrett Esophagus - pathology; Barrett Esophagus - surgery; Biological and medical sciences; Biomarkers, Tumor - analysis; Biomarkers, Tumor - metabolism; Carcinoma, Squamous Cell - chemistry; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Esophageal Neoplasms - chemistry; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hyperplasia; Investigative techniques, diagnostic techniques (general aspects); Leiomyoma - pathology; Male; Medical sciences; Middle Aged; Muscles; Myenteric Plexus - chemistry; Myenteric Plexus - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Precancerous Conditions - chemistry; Precancerous Conditions - pathology; Retrospective Studies; Seedlings; Tumors; Leiomyoma; Surgical specimen; Sporadic; Hyperplasia; Esophageal disease; Smooth muscle; Surgical resection; Esophagus carcinoma; Malignant tumor; Precursor; Gastrointestinal stromal tumor; GIST precursor; Seedling leiomyoma; Anatomic pathology; Follow up study; Distal; Cajal cell; Digestive diseases; Benign neoplasm; ICC hyperplasia
• ISSN: 0945-6317; 1432-2307
• DOI: 10.1007/s00428-005-0117-x

Interstitial cell of Cajal (ICC) hyperplasia has been documented in conditions associated with multiple gastrointestinal stromal tumours (GISTs) (familial GIST syndromes, Carney's triad and von Recklinghausen's disease) and rarely in the vicinity of sporadic GISTs. The incidence of sporadic ICC hyperplasia and the so-called seedling leiomyoma (SLM) of the lower oesophagus has not been studied in the KIT era. In a retrospective review of 77 consecutive, routinely processed oesophagogastric resection specimens for distal oesophageal carcinoma, we found foci of ICC hyperplasia in 7 of 77 (9.1%) cases and foci of SLM in 17 of 77 (22%) cases. Two types of ICC hyperplasia were recognized: a non-circumscribed type and a nodular expansile type with peripherally compressed myenteric neural tissues. All cases of ICC hyperplasia were vimentin+/CD34+/CD117+. SLMs were desmin+/vimentin(-)/CD34(-)/CD117(-), similar to smooth muscles of the gut wall. In a prospective study of 32 non-carcinomatous specimens from age-matched patients (mostly autopsy cases), we found SLMs in only one case, but we were unable to detect ICC hyperplasia in any of the cases. We concluded that sporadic KIT-positive spindle-cell hyperplasia and SLMs were unexpectedly common in distal oesophageal specimens harbouring carcinomas. The possible mechanisms leading to the development of these putative precursor lesions will be discussed.