Two Cases of Endoscopic Resection of Submucosal Tumor of the Minor Papilla / 대한소화기내시경학회지

Tumors of the minor papilla are very rare and these tumors have generally been known as neuroendocrine tumors such as carcinoid tumor and somatostatinoma. As these are mostly submucosal tumors, their diagnosis is difficult by just performing endoscopic forceps biopsy, but diagnosis is possible by surgery or endoscopic resection. EUS and ERCP is an essential tool for the diagnosis of these tumors, and abdominal CT or MRI is also useful because there is the possibility of malignant tumors such as carcinoid tumor. For our present two cases, screening endoscopy revealed the polypoid lesion of the minor papilla. EUS disclosed that the submucosal tumor was limited to the submucosal layer and no abnormality was found from the abdominal CT and ERCP. Herein, we performed endoscopic resection for making the diagnosis and treatment. Histologically, these 2 tumors were diagnosed as ectopic pancreas and gangliocytic paraganglioma, respectively.

Comparison of Immunohistochemical Staining of bcl-2 and PCNA in Keratoacanthoma and Squamous Cell Carcinoma / 대한피부과학회지

BACKGROUND: The function of the bcl-2 oncogene was known to prolong cell life by inhibiting apoptosis. PCNA have been used as a cellular proliferation marker. Because there are much similarities between Keratoacanthoma(KA) and Squamous Cell Carcinoma(SCC), it is often hard to differentiate KA and SCC, clinically and histopathologically. Although a number of recent studies have been attempted to separate these two entities by immunohistochemical stains, the distinction between KA and SCC may be still debatable and a matter of speculation. OBJECTIVE: The purpose of this study was to evaluate the usefullness of the method by analyzing immunohistochemical expression of bcl-2 and PCNA in a matter of differentiating KA and SCC. METHOD: 11 cases of Keratoacanthoma and 22 cases of Squamous Cell Carcinoma which are conformed by histopathologic examination were stained with bcl-2 and PCNA immunohistochemically. RESULTS: 1. In KA, The bcl-2 was negative in 100% and the PCNA was positive in 100%. 2. In SCC, The bcl-2 was negative in 95% and the PCNA was positive in 100%. 3. In the pattern of staining of PCNA, KA have more peripheral pattern(73%) than diffuse pattern(27%), otherwise SCC have more diffuse pattern(59%) than peripheral(27%) and focal pattern(14%). CONCLUSION: bcl-2, PCNA, Keratoacanthoma(KA), Squamous Cell Carcinoma(SCC)Our research showed that KA is almost similar to SCC except that there are difference in the pattern of staining of PCNA. According to the result of our study, we think that it is hard to differentiate between KA and SCC only by immunohistochemical staining of PCNA. Althogh immunohistochemical staining of PCNA would not be a confirmative method, it will help us to distinguish KA from SCC as a supplementary measure. By the fact, more researches are necessary to differentiate KA and SCC by immunohistochemical staining.