Nuclear artifacts in gastric endoscopic submucosal dissection specimens: A clinicopathological study

Matsukuma,Susumu; Takeo,Hiroaki; Sato,Kimiya

doi:10.3892/mco.2014.322

September-October 2014 Volume 2 Issue 5

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September-October 2014 Volume 2 Issue 5

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Article

Nuclear artifacts in gastric endoscopic submucosal dissection specimens: A clinicopathological study

Authors:
- Susumu Matsukuma
- Hiroaki Takeo
- Kimiya Sato
View Affiliations / Copyright

Affiliations: Health Care Center, Japan Self‑Defense Forces Central Hospital, Tokyo 154‑0001, Japan, Department of Pathology, Japan Self‑Defense Forces Central Hospital, Tokyo 154‑0001, Japan
Pages: 882-886
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Published online on: June 20, 2014

https://doi.org/10.3892/mco.2014.322
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Abstract

To delineate the characteristics of nuclear artifacts associated with endoscopic submucosal dissection (ESD), we examined 97 gastric ESD specimens from 79 patients. In 69 of the specimens (71%), multinucleated figures and̸or atypical mitotic‑like figures, including tripolar‑like and bizarre spindles, were found in the peripheral portions close to the marking areas. These nuclear figures were mostly recognizable as artifacts, but were infrequently (13 specimens) accompanied by other nuclear alterations and/or architectural abnormalities, mimicking dysplasia. However, in the deep cut sections, the dysplastic characteristics tended to disappear and coagulative or degenerative findings became more prominent. These nuclear artifacts were not found in 69 age‑ and gender‑matched control gastrectomy specimens without ESD. Multinucleated artifacts were associated with the size of the ESD specimens (P=0.003), frequency of marking (P<0.001) and a history of ‘previous’ marking 1‑6 days prior to ESD (P<0.001); however, they were not associated with age, ESD procedure time, or ‘fresh’ marking on the day of the ESD. Atypical mitosis‑like characteristics were associated with a history of ‘fresh’ (P=0.007) as well as ‘previous’ (P=0.002) marking, but not with other variables. Dysplasia‑like artifacts were associated with older age only (P=0.031). Follow‑up data of all the patients with nuclear artifacts showed no aggressive behavior. Therefore, we concluded that these nuclear changes were ESD‑related artifacts. Particularly in older patients, these changes may simulate dysplasia and must be distinguished from true dysplasia or neoplasia.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Nuclear artifacts in gastric endoscopic submucosal dissection specimens: A clinicopathological study

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