Synchronous occurrence of carcinoid, signet-ring cell carcinoma and heterotopic pancreatic tissue in stomach: A case report and literature review

Table 1 Immunohistochemical phenotypes of different mucosal lesions and various components of heterotopic pancreatic tissue in gastric wall

Markers	Mucosal lesions			Heterotopic pancreas (Lesion 3)
	Carcinoid (Lesion 1)	NE cell hyperplasia	SRC (Lesion 2)	Endocrine cell hyperplasia	Islets	Acini	Ducts
CK18	+++	+++	+++	+	+	++	++
Vimentin	-	-	-	-	-	-	-
NSE	++	+-++	-	+++	+++	-	+
CgA	+++	+++	-	+++	+++	-	+
Synaptophysin	+++	+++	-	+++	+++	-	+
Insulin	-	-	-	+++	+++	-	±
Glucagon	-	-	-	++	++	-	+
Somatostatin	-	+	-	++	++	±	±
Gastrin	-	++	-	++	++	-	±
VIP	±	+	-	±	±	-	-
ACTH	-	-	-	-	-	-	-
PP	-	-	-	-	-	+	±
p53 protein	2%	-	-	-	-	-	-
Ki-67-LI	2%	< 1%	20%	1%	< 1%	3%	5%

ACTH: adrenocorticotropin; CK18: cytokeratin 18; CgA: chromogranin A; Ki-67-LI: Ki-67-lebelling index; PP: pancreatic peptide; NE: neuroendocrine; NSE: neuron-specific enolase; SRC: signet-ring cell carcinoma; VIP: vasoactive intestinal peptide.