96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Abstracts
Results. Amplification of the FGFR1 region was rare, but could be found
in three of 128 cases of pancreatic ductal adenocarcinoma (3/128; 2.3%) in
our collective. Slightly more protein expression of FGFR1 was observed
with commercially available FGFR1 antibodies by standard immunohistochemistry.
So far, none of the pancreatic carcinoma cell lines showed
FGFR1 amplification.
Conclusions. FGFR1 amplification can be identified in a small subset of
pancreatic adenocarcinomas. FGFR1 is a tyrosine kinase receptor protein
which is able to promote tumor progression by altering angiogenesis, tumor
cell proliferation, migration and cell survival. In the future, it will
be necessary to characterize the biological role of FGFR1 amplification
in pancreatic adenocarcinoma. Further studies are needed to determine,
whether the patients with FGFR1 amplification and/or overexpression
need to be pre-selected prior to TKI treatment.
FR-P-095
Paraduodenal pancreatitis: mini-series with regard to vessel
obliteration
T . Hansen1 , F . Vitali2 , R . Kießlich3 , S . Heinrich4 , P . Mildenberger5 , A . Kumar5 ,
L . Frulloni2 , C .J . Kirkpatrick1 1 2 University of Mainz, Institute of Pathology, Mainz, University of Verona,
Department of Medicine, Verona, Italy, 3University of Mainz, Department of
Internal Medicine, Mainz, 4University of Mainz, Department of General and
Abdominal Surgery, Mainz, 5University of Mainz, Department of Radiology,
Mainz
Aims. Paraduodenal pancreatitis comprises a form of chronic pancreatitis
involving the duodenal wall close to the minor papilla within the surrounding
parenchymal tissue and common bile duct (also called groove
area). This disorder most commonly affects male patients in the 5th decade
with a history of alcohol and/or nicotine abuse. Concerning the pathogenesis,
it is believed that alcohol or smoking leads to a resistance of
the pancreatic juice flow and ischemia of the paraduodenal tissue, giving
relapsing episodes of pancreatitis. We report on a series of patients with
paraduodenal pancreatitis with emphasis on vascular changes.
Methods. We describe ten patients (all male, mean age 45.4 yrs). Most of
them presented with abdominal pain (n=8), and weight loss was additionally
found in eight patients as well. All patients were smokers; history
of alcohol abuse could be confirmed in seven cases. In all patients, a
pancreatico-duodenectomy was performed. For histological evaluation,
tissue specimens were routinely processed.
Results. The following characteristic histological phenomena of paraduodenal
pancreatitis were observed: Brunner’s gland hyperplasia occurred
in all cases, while cystic changes of the duodenal wall and adenomyomatosis
of the duodenal wall were found in 9/10 patients. Variable
numbers of a mixed inflammatory infiltrate were present in all patients
analyzed. In 50%, we found foreign body giant cell reaction in the neighbourhood
of some pseudocysts. However, most interestingly obliteration
of segmental arteries was present in 6/10 cases.
Conclusions. This histological study confirms the common morphological
changes in paraduodenal pancreatitis. Interestingly, we found vessel
obliteration in several cases, which has not been described for this subtype
of chronic pancreatitis so far. It remains to be investigated whether
this specific finding might reflect a particular subgroup of paraduodenal
pancreatitis.
114 | Der Pathologe · Supplement 1 · 2012
FR-P-096
Diagnostic value of immunohistochemical IMP3 expression in
core needle biopsies of pancreatic ductal adenocarcinoma
D .L . Wachter1 , A . Schlabrakowski2 , J . Hoegel3 , G . Kristiansen4 , A . Hartmann1 ,
M .-O . Riener1 1University Hospital Erlangen-Nuremberg, Institute of Pathology, Erlangen,
2 3 Nuremberg Clinic Center, Insitute of Pathology, Institute of Human Genetics,
University Hospital Ulm, 4University Hospital Zurich, Zürich, Switzerland
Aims. The oncofetal protein, insulin-like growth factor-II messenger
ribonucleic acid-binding protein 3 (IMP3), has been analyzed in many
different tumors. Various studies have found that IMP3 is a marker for
malignancy and is correlated with increased tumor aggressiveness and
reduced overall survival. The diagnosis of pancreatic ductal adenocarcinoma
(PDAC) in core needle biopsies can be challenging, and immunohistochemical
markers are needed.
Methods. We studied IMP3 expression in 177 core needle biopsies of the
pancreas, including 112 PDACs, 55 cases with chronic sclerosing pancreatitis,
and 10 biopsies with tumor-free pancreatic tissue without inflammation.
An additional 18 biopsies of PDAC metastases (16 liver biopsies
and 2 lymph node biopsies) were analyzed. To study IMP3 expression in
large tissue sections, 45 pancreatic resection specimens (26 with PDAC
and 19 with chronic sclerosing pancreatitis) were investigated.
Results. In contrast to normal or inflamed pancreatic tissue, which was
negative in 47 of 65 (72.3%) cases and weakly positive in 15 of 65 (23.1%)
cases, strong IMP3 expression was found in 99 of 112 (88.4%) PDACs.
Therefore, sensitivity and specificity of IMP3 expression in the differential
diagnosis of PDAC and chronic sclerosing pancreatitis using core
needle biopsies were found to be 88.4% and 94.6%, respectively. These
results were confirmed in the pancreas resection specimens. Furthermore,
strong IMP3 expression was found in 17 of 18 (94.4%) of the PDAC
metastases that were analyzed.
Conclusions. Our study shows that IMP3 is an easy to use and potentially
new immunohistochemical marker for the diagnosis of PDAC in core
needle biopsies.
FR-P-097
Molecular analysis of putative therapeutic targets in pancreatic
acinar cell carcinomas
F . Bergmann1 , H . Bläker2 , A . Harjung1 , P . Mayer1 , B . Sipos3 , G . Klöppel4 ,
P . Schirmacher1 1 2 University of Heidelberg/ Institute of Pathology, Heidelberg, Charité Berlin,
Institute of Pathology, 3University of Tübingen, Institute of Pathology, 4Tech nical University Munich, Institute of Pathology
Aims. Pancreatic acinar cell carcinomas represent aggressive tumors who
frequently display metastases at the time of diagnosis. Because they are
rare, established therapeutic concepts other than surgery practically do
not exist. The aim of the present study was to evaluate established and innovative
therapeutic markers in these to date poorly understood tumors.
Methods. Putative therapeutic targets were investigated by means of direct
sequencing, immunohistochemistry, and/or Western blot analyses
in a series of 60 pancreatic acinar cell carcinomas.
Results. 4% of the tumors displayed k-ras mutations. While 40% of the
acinar cell carcinomas showed immunohistochemical expression of
EGFR, no EGFR mutations were detected. Heat shock protein 90, heat
shock protein 70, L1CAM, and Her2/neu were expressed in 100%, 90%,
65%, and 0% of the tumors, each. mgMT deficiency was found in 28% of
the tumors.
Conclusions. EGFR, heat shock proteins 90 and 70, L1CAM, and mgMT
represent promising targets and predictive markers for the therapy of
inoperable or progressive pancreatic acinar cell carcinomas.