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Multiple adenomatoid tumours in the liver and peritoneum
  1. Stephen J Hayes1,
  2. Peter Clark1,
  3. Richard Mathias1,
  4. Laura Formela2,
  5. Jonathan Vickers2,
  6. Gordon R Armstrong3
  1. 1Department of Histopathology, Hope Hospital, Salford, UK
  2. 2Department of Surgery, Hope Hospital, Salford, UK
  3. 3Department of Histopathology, Hope Hospital, Salford, UK
  1. Correspondence to:
 Dr S J Hayes
 Department of Histopathology, Hope Hospital, Stott Lane, Salford M6 8HD, UK; stephen.hayes{at}srht.nhs.uk

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Adenomatoid tumours are uncommon tumours, which were first described by Golden and Ash.1 They occur most often in the male and female genital tracts, but have rarely been reported at other sites such as the omentum,2 pleura,3 heart,4 small bowel mesentery5 and adrenal gland.6

We report multiple adenomatoid tumours involving the peritoneum and liver. Our diagnosis was based on morphological examination, and was supported by histochemical, immunohistochemical and ultrastructural examinations.

Materials and methods

Tissue was processed for frozen sections using a cryostat, and sections were stained with H&E.

Formalin-fixed paraffin wax sections of each tumour were stained with periodic acid-Schiff after diastase predigestion, in addition to H&E staining. Immunohistochemical staining for cytokeratins (CK) 5, 6, 8, 17 and 19 (clone MNF116, DAKO cytomation), CK5/6 (clone D5/16B4, DAKO cytomation), epithelial membrane antigen (EMA; clone E29, DAKO cytomation), epithelial antigen (clone BEREP4, DAKO cytomation), calretinin (clone DAK-calret DAKO cytomation), mesothelial cell (clone human bone marrow endothelial (HBME)-1 DAKO cytomation), CD31 (DAKO) and CD34 (DAKO) was performed using an automated immunostainer (DAKO Autostainer, Ely, UK) and a labelled streptavidin–biotin method.

Electron microscopy was performed on tissue retrieved from paraffin-wax-embedded blocks, post-fixed in osmium tetroxide, and stained with uranyl acetate and lead citrate. Microscopy was performed on 80–90 nm sections using a Hitachi H600 transmission electron microscope (Hitachi, Wokingham, UK).

Results

A 74-year-old woman presented with coffee ground vomiting associated with malaena. She also had a history of Helicobacter pylori infection and eradication therapy, glaucoma and hypertension. There was no history of previous surgery. Her medication consisted of a proton pump inhibitor, a β-blocker and eye drops for glaucoma. There was no relevant family history.

An oesophago-gastro-duodenoscopy showed a chronic ulcer involving the lesser curve of the stomach and a positive campylobacter-like organism test. A biopsy specimen was taken, which showed the …

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