Pyloric Gland Type Adenoma of the Gallbladder with Squamoid Spindle Cell Metaplasia*

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SUMMARY

This study documents a pyloric gland type adenoma o f the gallbladder with prominent spindle cell meta plasia arising in a 61 year old woman. A pedunculated polyp, 1.S x 1.0 x 1.0 cm, was histologically diagnosed as a tubular adenoma. Most glandular structures showed positivity for a monoclonal antibody M2 (2B5) which indicates a differentiation to pyloric gland type. The spindle cell component displayed no apparent epithelial structures but stained mostly positive for pancytokeratin and cytokeratin (CK) 18, and focally for CK S + 6, CKs 7 and 19, whereas CKs 8, 13, 20, and non-epithelial markers could not be demonstrated. This suggests that the spindle cells were immature epithelial cells differentiating towards squamous and/or glandular cells. Even in spindle cell areas, the nuclear atypia was mild, and proliferating cells positive for MIB-1 (Ki-67) antigen were infrequently seen. This unique phenomenon, o f which only three cases have been previously reported, is considered to represent benign squamoid spindle cell metaplasia.

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    Prof. Dr. F. Borchard, Institute of Pathology, Heinrich-Heine-University, MoorenstraBe 5, D-40225 Düsseldorf, Germany, Tel.: +49-211-81-18341, FAX: +49-211-81-18353

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