Difference between revisions of "Goblet cell adenocarcinoma"
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| Subtypes = | | Subtypes = | ||
| LMDDx = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]] | | LMDDx = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]] | ||
| Stains = | | Stains = [[alcian blue stain|alcian blue]] +ve, [[PASD stain|PASD]] +ve, [[mucicarmine stain|mucicarmine]] +ve | ||
| IHC = synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve | | IHC = synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = usu. no mass apparent | ||
| Grossing = | | Grossing = | ||
| Site = [[vermiform appendix]], elsewhere in the GI tract | | Site = [[vermiform appendix]], elsewhere in the GI tract | ||
| Line 20: | Line 20: | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = rare | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = moderate | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology | ||
}} | }} | ||
'''Crypt cell carcinoma''', also known as '''goblet cell carcinoid'''<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref><ref>{{Cite journal | last1 = Pahlavan | first1 = PS. | last2 = Kanthan | first2 = R. | title = Goblet cell carcinoid of the appendix. | journal = World J Surg Oncol | volume = 3 | issue = | pages = 36 | month = Jun | year = 2005 | doi = 10.1186/1477-7819-3-36 | PMID = 15967038 }}</ref> | '''Crypt cell carcinoma''', also known as '''goblet cell carcinoid'''<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref><ref>{{Cite journal | last1 = Pahlavan | first1 = PS. | last2 = Kanthan | first2 = R. | title = Goblet cell carcinoid of the appendix. | journal = World J Surg Oncol | volume = 3 | issue = | pages = 36 | month = Jun | year = 2005 | doi = 10.1186/1477-7819-3-36 | PMID = 15967038 }}</ref> | ||
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*Rare appendiceal tumour that typically has an aggressive course vis-a-vis other appendiceal carcinoids.<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref> | *Rare appendiceal tumour that typically has an aggressive course vis-a-vis other appendiceal carcinoids.<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref> | ||
*Mixed (biphasic) tumour with endocrine and exocrine features. | *Mixed (biphasic) tumour with endocrine and exocrine features. | ||
*Usually presents as [[acute appendicitis]].<ref name=pmid15967038/> | |||
**Less common presentations: appendiceal mass, pain. | |||
*Five year survival in one series: 60-85%.<ref name=pmid15967038/> | |||
==Gross== | |||
*Typically no mass is apparent at gross.<ref name=pmid15967038/> | |||
==Microscopic== | ==Microscopic== | ||
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==Stains== | ==Stains== | ||
*Mucin stains +ve: | *Mucin stains +ve: | ||
**Mucicarmine, perodic acid-Schiff diastase (PAS-D), | **Mucicarmine, perodic acid-Schiff diastase (PAS-D), alcian blue. | ||
==IHC== | |||
*Classic neuroendocrine markers: | *Classic neuroendocrine markers: | ||
**Synaptophysin +ve. | **Synaptophysin +ve. | ||
Revision as of 14:32, 27 September 2013
| Goblet cell adenocarcinoma | |
|---|---|
| Diagnosis in short | |
 Crypt cell carcinoma. H&E stain. | |
|
| |
| LM | small clusters of cells with stippled chromatin and a goblet cell-like appearance |
| LM DDx | signet ring cell carcinoma, appendiceal neuroendocrine tumour |
| Stains | alcian blue +ve, PASD +ve, mucicarmine +ve |
| IHC | synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve |
| Gross | usu. no mass apparent |
| Site | vermiform appendix, elsewhere in the GI tract |
|
| |
| Prevalence | rare |
| Prognosis | moderate |
| Clin. DDx | acute appendicitis, other appendiceal tumours, other abdominal pathology |
Crypt cell carcinoma, also known as goblet cell carcinoid[1][2] and neuroendocrine tumour with goblet cell differentiation, is a rare malignant tumour that is typically seen in the vermiform appendix.
General
- Rare appendiceal tumour that typically has an aggressive course vis-a-vis other appendiceal carcinoids.[1]
- Mixed (biphasic) tumour with endocrine and exocrine features.
- Usually presents as acute appendicitis.[3]
- Less common presentations: appendiceal mass, pain.
- Five year survival in one series: 60-85%.[3]
Gross
- Typically no mass is apparent at gross.[3]
Microscopic
Features:[3]
- Mixed neuroendocrine-nonneuroendocrine tumour;[4] features of both carcinoid and adenocarcinoma.[3]
- Archictecture: cells arranged in nests or clusters without a lumen.
- Location: deep to the intestinal crypts (crypts of Lieberkühn); usually do not involve the mucosa.
- Cytoplasm distended with mucin.
- DNA: crescentic nucleus (similar to in signet-ring cells).
- +/-Multinucleation.
- +/-High mitotic rate.
- Usually minimal nuclear atypia.
DDx:
- Appendiceal neuroendocrine tumour.
- Signet ring cell carcinoma - cell detached.
Images
CCC - very high mag. (WC/Nephron)
CCC - very low mag. (WC/Nephron)
Stains
- Mucin stains +ve:
- Mucicarmine, perodic acid-Schiff diastase (PAS-D), alcian blue.
IHC
- Classic neuroendocrine markers:
- Synaptophysin +ve.
- Chromogranin +ve.
- S-100 +ve.
- NSE +ve.
- Serotonin +ve.
Keratins:
- Usually CK20 +ve > CK7 +ve.
- CEA +ve (membrane).
Notes:
- Nice review of stains in Pahlavan and Kanthan.[3]
See also
References
- ↑ 1.0 1.1 van Eeden S, Offerhaus GJ, Hart AA, et al. (December 2007). "Goblet cell carcinoid of the appendix: a specific type of carcinoma". Histopathology 51 (6): 763–73. doi:10.1111/j.1365-2559.2007.02883.x. PMID 18042066.
- ↑ Pahlavan, PS.; Kanthan, R. (Jun 2005). "Goblet cell carcinoid of the appendix.". World J Surg Oncol 3: 36. doi:10.1186/1477-7819-3-36. PMID 15967038.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Pahlavan PS, Kanthan R (June 2005). "Goblet cell carcinoid of the appendix". World J Surg Oncol 3: 36. doi:10.1186/1477-7819-3-36. PMC 1182398. PMID 15967038. http://wjso.com/content/3/1/36. Cite error: Invalid
<ref>tag; name "pmid15967038" defined multiple times with different content Cite error: Invalid<ref>tag; name "pmid15967038" defined multiple times with different content - ↑ Volante M, Righi L, Asioli S, Bussolati G, Papotti M (August 2007). "Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms". Virchows Arch. 451 Suppl 1: S61–9. doi:10.1007/s00428-007-0447-y. PMID 17684764.