Difference between revisions of "Goblet cell adenocarcinoma"
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| ClinDDx = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology | | ClinDDx = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology | ||
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''' | '''Goblet cell adenocarcinoma''' is a rare malignant tumour that is typically seen in the [[vermiform appendix]].<ref>{{cite journal |authors=Kiyosawa N, Koyama M, Miyagawa Y, Kitazawa M, Tokumaru S, Soejima Y |title=Goblet cell adenocarcinoma of the appendix: A case report of three cases |journal=Int J Surg Case Rep |volume=106 |issue= |pages=108229 |date=April 2023 |pmid=37084554 |doi=10.1016/j.ijscr.2023.108229 |url=}}</ref> | ||
and '''[[neuroendocrine tumour]] with goblet cell differentiation''' | |||
It has gone by a number of different names in the past: '''crypt cell carcinoma''', '''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 name=pmid15967038>{{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> | |||
and '''[[neuroendocrine tumour]] with goblet cell differentiation'''. | |||
==General== | ==General== | ||
Revision as of 17:41, 27 April 2023
| 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, poorly differentiated adenocarcinoma |
| 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 |
|
| |
| Clinical history | "acute appendicitis" |
| Prevalence | rare |
| Prognosis | moderate |
| Clin. DDx | acute appendicitis, other appendiceal tumours, other abdominal pathology |
Goblet cell adenocarcinoma is a rare malignant tumour that is typically seen in the vermiform appendix.[1]
It has gone by a number of different names in the past: crypt cell carcinoma, goblet cell carcinoid[2][3] and neuroendocrine tumour with goblet cell differentiation.
General
- Rare appendiceal tumour that typically has an aggressive course vis-a-vis other appendiceal carcinoids.[2]
- 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]
Note:
- Should be submitted in total.
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).
- +/-Multi-nucleation.
- +/-High mitotic rate.
- Usually minimal nuclear atypia.
DDx:
- Appendiceal neuroendocrine tumour.
- Signet ring cell carcinoma[5] - cells more detached, no neuroendocrine differentiation.
- Poorly differentiated adenocarcinoma - see colorectal carcinoma.
Images
Case 1
CCC - low mag. (WC/Nephron)
CCC - intermed. mag. (WC/Nephron)
CCC - high mag. (WC/Nephron)
CCC - very high mag. (WC/Nephron)
CCC - intermed. mag. (WC/Nephron)
CCC - high mag. (WC/Nephron)
CCC - very high mag. (WC/Nephron)
Case 2
Goblet cell carcinoid - high power (SKB)
Appendix - Goblet cell carcinoid - high power (SKB)
Appendix - Goblet cell carcinoid - medium power (SKB)
Appendix - Goblet cell carcinoid - high power (SKB)
Appendix - Goblet cell carcinoid - high power (SKB)
Appendix - Goblet cell carcinoid - high power (SKB)
Appendix - Goblet cell carcinoid - high power (SKB)
_PA.JPG)
_-_Copy_PA.JPG)
_-_Copy_PA.JPG)
_PA.JPG)
Stains
- Mucin stains +ve:
IHC
- Classic neuroendocrine markers:
- Synaptophysin +ve.
- Chromogranin +ve.
- S-100 +ve.
- NSE +ve.
- Serotonin +ve.
Keratins:
- CEA +ve (membrane).
Notes:
- Review of stains in Pahlavan and Kanthan.[3]
See also
References
- ↑ Kiyosawa N, Koyama M, Miyagawa Y, Kitazawa M, Tokumaru S, Soejima Y (April 2023). "Goblet cell adenocarcinoma of the appendix: A case report of three cases". Int J Surg Case Rep 106: 108229. doi:10.1016/j.ijscr.2023.108229. PMID 37084554.
- ↑ 2.0 2.1 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.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 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.
- ↑ 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.
- ↑ Pericleous, M.; Lumgair, H.; Baneke, A.; Morgan-Rowe, L.; E Caplin, M.; Luong, TV.; Thirlwell, C.; Gillmore, R. et al. (May 2012). "Appendiceal goblet cell carcinoid tumour: a case of unexpected lung metastasis.". Case Rep Oncol 5 (2): 332-8. doi:000339607. PMID 22933998.