Biotin-rich intranuclear inclusions in morule-lacking adenocarcinoma of the gallbladder: a new category of "neoplastic/non-morular" lesions

Virchows Arch. 2005 Feb;446(2):194-9. doi: 10.1007/s00428-004-1161-7. Epub 2005 Jan 13.

Abstract

Biotin-rich intranuclear inclusions, also called "optically clear nuclei," are observed in various neoplastic and non-neoplastic lesions, including pregnancy-related endometrium and benign and malignant neoplasms with morular structures. A recent study reported that lesions with biotin-rich intranuclear inclusions can be classified as "(non-neoplastic) pregnancy-related endometrial" and as "(neoplastic) morular" category. In the present report, we describe two cases of well-differentiated adenocarcinoma of the gallbladder in which biotin-rich intranuclear inclusions were found without morular structures. Immunohistochemically, as reported previously, the intranuclear inclusions were positive for biotin and two biotin-binding enzymes (pyruvic acid carboxylase and propionyl CoA carboxylase). Intranuclear expression of beta-catenin was also observed in neoplastic cells with and without intranuclear inclusion. We also detected a frame shift mutation of APC gene in one case but no mutation of beta-catenin gene in both cases. Although intranuclear expression of beta-catenin by mutation of APC gene might contribute to carcinogenesis in our cases, the relationships among intranuclear expressions of beta-catenin, biotin, biotin-binding enzymes and intranuclear inclusions remain unclear. Our cases are the first neoplastic lesions with biotin-rich intranuclear inclusions that lacked morular structures. We propose a new "neoplastic/non-morular" category for lesions with biotin-rich intranuclear inclusions.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / chemistry*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology*
  • Aged
  • Biotin / analysis*
  • Cell Nucleus / chemistry*
  • Cytoskeletal Proteins / analysis
  • Cytoskeletal Proteins / genetics
  • DNA Mutational Analysis
  • Female
  • Frameshift Mutation
  • Gallbladder Neoplasms / chemistry*
  • Gallbladder Neoplasms / genetics
  • Gallbladder Neoplasms / pathology*
  • Humans
  • Immunohistochemistry
  • Male
  • Methylmalonyl-CoA Decarboxylase / analysis
  • Mucin 5AC
  • Mucin-6
  • Mucins / analysis
  • Pyruvate Carboxylase / analysis
  • Trans-Activators / analysis
  • Trans-Activators / genetics
  • beta Catenin

Substances

  • CTNNB1 protein, human
  • Cytoskeletal Proteins
  • MUC5AC protein, human
  • MUC6 protein, human
  • Mucin 5AC
  • Mucin-6
  • Mucins
  • Trans-Activators
  • beta Catenin
  • Biotin
  • Pyruvate Carboxylase
  • Methylmalonyl-CoA Decarboxylase