Abstract
The mixt endocrine-exocrine carcinoma of the appendix, being a rare tumor, makes up a very little part of all gas­trointestinal system tumors. These tumors are thought to be the intermediary tumors taking place between adeno­carcinomas and endocrine tumors. Generally they are seen in the 5th -6th decades equally in males and females. Being very characteristic, the histomorphological picture of goblet cell carcinoid consists of atypical epithelial cells with conspicuous nucleoli that make small abortive glands demonstrating scattered nests under surface epithelium and containing Goblet cells. The tumor exhibits trans­mural spread producing mucin pools designating posi­tive immunoreaction histochemically with musicarmen stain. In addition to CEA and keratin expressions, there is neuroendocrine differentiation that may be illustrated both immunohistochemically and ultrastructurally. In our case, under the appendix epithelium we determined a tumor that was formed by gland structures lined by mu­cinous epithelial cells with conspicuous nucleoli, growing forward to the muscle layer and seeming invasive. We established that the tumor expressed PanCK, synapto­physin, chromogranin and CEA in immunohistochemi­cal study and stained positively with PAS, PAS-AB and musicarmen in histochemical study. We considered the case as goblet cell carcinoid when clinical, histopathologi­cal, histochemical and immunohistochemical data were assessed together. In the time interval 2 years after the operation, any recurrence and/or metastase was not de­termined.
References
- Varisco B, McAlvin B, Dias J, et al. Adenocarcinoid of ap- pendix: Is right hemicolectomy necessary? A meta-analysis of retrospective chart reviews. Am Surg 2004;70:593-9.
- Pahlavan PS, Kanthan R. Goblet cell carcinoid of the appen- dix. World J Surg Oncol 2005;3:1-11.
- Bucher P, Gervaz P, Ris F, Oulhaci W, Egger JF, Morel P. Surgical treatment of appendiceal adenocarcinoid (goblet cell carcinoid). World J Surg 2005;29:1436-9.
- Toumpanakis C, Standish RA, Baishnab E, Winslet MC, Ca- plin ME. Goblet cell carcinoid tumors (adenocarcinoid) of the appendix. Dis Colon Rectum 2007;50:315-22.
- Kanthan R, Saxena A, Kanthan SC. Goblet cell carcinoids of the appendix. Immunophenotype and ultrastructural study. Arch Pathol Lab Med 2001;125:386-90.
- Volante M, Righi L, Asioli S, Bussolati G, Papotti M. Goblet cell carcinoids and other mixed neuroendocrine/nonneuro- endocrine neoplasms. Virchows Arch 2007;451:61-9.
- Klöppel G, Perren A, Heitz PU. The Gastroenteropancreatic Neuroendocrine Cell System and Its Tumors: The WHO Classification. Ann NY Acad Sci 2004;1014:13-27.
Abstract
Apendiksin karışık endokrin-ekzokrin karsinomu, ender bir tümör olup, tüm gastrointestinal sistem tümörlerinin çok az bir kısmını oluşturmaktadır. Bu tümörlerin adeno­karsinom ve endokrin tümör arasında yer alan interme­diyer tümörler oldukları düşünülmektedir. Daha çok 5-6. dekadlarda, kadın ve erkeklerde eşit sıklıkta görülürler. Goblet hücreli karsinoid\'in histomorfolojik görünümü ol­dukça karakteristik olup, yüzey epiteli altında mukozada dağınık, yuvalanmalar gösteren ve Goblet hücreleri içeren küçük abortif glandlar yapan, belirgin nükleoluslu atipik epitelyal hücrelerden oluşur. Müsikarmen boyasıyla reak­siyon veren müsin gölcükleri yaparak transmural tutulum gösterir. Tümör hücrelerinde CEA ve keratin ekspresyonu yanısıra immünohistokimyasal ve/veya ultrastrüktürel ola­rak gösterilebilen nöroendokrin diferansiyasyon mevcut­tur. Vakamızda apendiks epiteli altında, kas içine doğru ilerleyen, çeşitli büyüklükte, invaziv görünümde, belirgin nükleoluslu, müsinöz epitelle döşeli gland yapılarından oluşan tümör tespit ettik. Tümörün immünohistokimyasal çalışmada PanCK, sinaptofizin, kromogranin ve CEA eks­prese ettiğini histokimyasal çalışmada ise PAS, PAS-AB ve müsikarmen ile pozitif boyandığını saptadık. Vaka kli­nik, histopatolojik, histokimyasal ve immünohistokimyasal bulgular birlikte ele alındığında goblet hücreli karsinoid olarak değerlendirildi. Operasyon sonrası geçen 2 yıllık sürede rekürrens ve/veya metastaz saptanmadı.
References
- Varisco B, McAlvin B, Dias J, et al. Adenocarcinoid of ap- pendix: Is right hemicolectomy necessary? A meta-analysis of retrospective chart reviews. Am Surg 2004;70:593-9.
- Pahlavan PS, Kanthan R. Goblet cell carcinoid of the appen- dix. World J Surg Oncol 2005;3:1-11.
- Bucher P, Gervaz P, Ris F, Oulhaci W, Egger JF, Morel P. Surgical treatment of appendiceal adenocarcinoid (goblet cell carcinoid). World J Surg 2005;29:1436-9.
- Toumpanakis C, Standish RA, Baishnab E, Winslet MC, Ca- plin ME. Goblet cell carcinoid tumors (adenocarcinoid) of the appendix. Dis Colon Rectum 2007;50:315-22.
- Kanthan R, Saxena A, Kanthan SC. Goblet cell carcinoids of the appendix. Immunophenotype and ultrastructural study. Arch Pathol Lab Med 2001;125:386-90.
- Volante M, Righi L, Asioli S, Bussolati G, Papotti M. Goblet cell carcinoids and other mixed neuroendocrine/nonneuro- endocrine neoplasms. Virchows Arch 2007;451:61-9.
- Klöppel G, Perren A, Heitz PU. The Gastroenteropancreatic Neuroendocrine Cell System and Its Tumors: The WHO Classification. Ann NY Acad Sci 2004;1014:13-27.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Reports |
| Authors | |
| Publication Date | March 1, 2013 |
| Submission Date | March 2, 2015 |
| Published in Issue | Year 2013 Volume: 40 Issue: 1 |