Difference between revisions of "Goblet cell adenocarcinoma"

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Goblet cell adenocarcinoma (view source)

Revision as of 17:53, 27 April 2023

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| Image      = Goblet_cell_carcinoid_-2-_very_high_mag.jpg
| Image      = Goblet_cell_carcinoid_-2-_very_high_mag.jpg
| Width      =
| Width      =
| Caption    = Crypt cell carcinoma. [[H&E stain]].
| Caption    = Goblet cell adenocarcinoma. [[H&E stain]].
| Micro      =
| Synonyms  = goblet cell carcinoid (obsolete term), crypt cell carcinoma
| Micro      = small clusters of cells with stippled chromatin and a goblet cell-like appearance
| Subtypes  =
| Subtypes  =
| LMDDx      =
| LMDDx      = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]], poorly differentiated adenocarcinoma
| Stains    =
| Stains    = [[alcian blue stain|alcian blue]] +ve, [[PASD stain|PASD]] +ve, [[mucicarmine stain|mucicarmine]] +ve
| IHC        =
| 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
| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx = "acute appendicitis"
| 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>  
'''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''', is a rare malignant tumour that is typically seen in the [[vermiform appendix]].
 
It has gone by a number of different names in the past: '''crypt cell carcinoma''',<ref>{{cite journal |authors=Limaiem F, Omrani S, Hajri M |title=Goblet cell adenocarcinoma of the ascending colon: An underrecognized diagnostic pitfall |journal=Clin Case Rep |volume=11 |issue=1 |pages=e6822 |date=January 2023 |pmid=36654693 |pmc=9834544 |doi=10.1002/ccr3.6822 |url=}}</ref> '''goblet cell carcinoid'''<ref>{{cite journal |authors=Sigley K, Franklin M, Welch S |title=Appendiceal Goblet Cell Adenocarcinoma Case Report and Review of the Literature |journal=Cureus |volume=13 |issue=2 |pages=e13511 |date=February 2021 |pmid=33786220 |pmc=7992912 |doi=10.7759/cureus.13511 |url=}}</ref><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==
*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-à-vis [[appendiceal carcinoid]]s.<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/>
Note:
*Should be [[submitted in total]].


==Microscopic==
==Microscopic==
Features:<ref name=pmid15967038>{{cite journal |author=Pahlavan PS, Kanthan R |title=Goblet cell carcinoid of the appendix |journal=World J Surg Oncol |volume=3 |issue= |pages=36 |year=2005 |month=June |pmid=15967038 |pmc=1182398 |doi=10.1186/1477-7819-3-36 |url=http://wjso.com/content/3/1/36}}</ref>
Features:<ref name=pmid15967038/>
*Mixed neuroendocrine-nonneuroendocrine tumour;<ref name=pmid17684764>{{cite journal |author=Volante M, Righi L, Asioli S, Bussolati G, Papotti M |title=Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms |journal=Virchows Arch. |volume=451 Suppl 1 |issue= |pages=S61–9 |year=2007 |month=August |pmid=17684764 |doi=10.1007/s00428-007-0447-y |url=}}</ref> features of both ''carcinoid'' and ''adenocarcinoma.<ref name=pmid15967038>PMID 15967038.</ref>
*Mixed neuroendocrine-nonneuroendocrine tumour;<ref name=pmid17684764>{{cite journal |author=Volante M, Righi L, Asioli S, Bussolati G, Papotti M |title=Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms |journal=Virchows Arch. |volume=451 Suppl 1 |issue= |pages=S61–9 |year=2007 |month=August |pmid=17684764 |doi=10.1007/s00428-007-0447-y |url=}}</ref> features of both ''carcinoid'' and ''adenocarcinoma.<ref name=pmid15967038/>
**Archictecture: cells arranged in nests or clusters without a lumen.
**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.
**Location: deep to the intestinal crypts (crypts of Lieberkühn); usually do not involve the mucosa.
**Cytoplasm distended with mucin.
**Cytoplasm distended with mucin.
**DNA: crescentic nucleus (similar to in signet-ring cells).
**DNA: crescentic nucleus (similar to in signet ring cells).
***+/-Multinucleation.
***+/-Multi-nucleation.
***+/-High mitotic rate.
***+/-High mitotic rate.
***Usually minimal nuclear atypia.
***Usually minimal [[nuclear atypia]].
 
DDx:
*[[Appendiceal neuroendocrine tumour]].
*[[Signet ring cell carcinoma]]<ref name=pmid22933998>{{Cite journal  | last1 = Pericleous | first1 = M. | last2 = Lumgair | first2 = H. | last3 = Baneke | first3 = A. | last4 = Morgan-Rowe | first4 = L. | last5 = E Caplin | first5 = M. | last6 = Luong | first6 = TV. | last7 = Thirlwell | first7 = C. | last8 = Gillmore | first8 = R. | last9 = Toumpanakis | first9 = C. | title = Appendiceal goblet cell carcinoid tumour: a case of unexpected lung metastasis. | journal = Case Rep Oncol | volume = 5 | issue = 2 | pages = 332-8 | month = May | year = 2012 | doi = 000339607 | PMID = 22933998 }}</ref> - cells more detached, no neuroendocrine differentiation.
*Poorly differentiated [[adenocarcinoma]] - see ''[[colorectal carcinoma]]''.


===Images===
===Images===
====Case 1====
<gallery>
Image:Goblet cell carcinoid - low mag.jpg| CCC - low mag. (WC/Nephron)
Image:Goblet cell carcinoid - intermed mag.jpg| CCC - intermed. mag. (WC/Nephron)
Image:Goblet cell carcinoid - high mag.jpg| CCC - high mag. (WC/Nephron)
Image:Goblet cell carcinoid - very high mag.jpg| CCC - very high mag. (WC/Nephron)
</gallery>
<gallery>
Image:Goblet cell carcinoid -2- intermed mag.jpg| CCC - intermed. mag. (WC/Nephron)
Image:Goblet cell carcinoid -2- high mag.jpg| CCC - high mag. (WC/Nephron)
Image:Goblet cell carcinoid -2- very high mag.jpg| CCC - very high mag. (WC/Nephron)
</gallery>
====Case 2====
<gallery>
<gallery>
Image:Goblet_cell_carcinoid_-2-_very_high_mag.jpg | CCC - very high mag. (WC/Nephron)
Image:Appendix Carcinoid GobletCell HP PA.JPG|Goblet cell carcinoid - high power (SKB)
Image:Goblet_cell_carcinoid_-_very_low_mag.jpg | CCC - very low mag. (WC/Nephron)
Image:Appendix Carcinoid GobletCell HP (5) PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell MP PA.JPG|Appendix - Goblet cell carcinoid - medium power (SKB)
Image:Appendix Carcinoid GobletCell HP (4) - Copy PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP (3) - Copy PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP-2 PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP-2 (2) PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
</gallery>
</gallery>


==Stains==
==Stains==
*Mucin stains +ve:
*Mucin stains +ve:
**Mucicarmine, perodic acid-Schiff diastase (PAS-D), alician blue.
**[[mucicarmine stain|Mucicarmine]], [[PASD stain|periodic acid-Schiff diastase stain]] (PAS-D), [[alcian blue stain|alcian blue]].


===IHC===
==IHC==
*Classic neuroendocrine markers:
*Classic neuroendocrine markers:
**Synaptophysin +ve.
**Synaptophysin +ve.
**Chromogranin +ve.
**Chromogranin +ve.
*S100 +ve.
*[[S-100]] +ve.
*NSE +ve.
*NSE +ve.
*Serotonin +ve.
*Serotonin +ve.


Keratins:
Keratins:
*Usually CK20 +ve > CK7 +ve.
*Usually [[CK20]] +ve > [[CK7]] +ve.


*CEA +ve (membrane).
*CEA +ve (membrane).


Notes:
Notes:
*Nice review of stains in Pahlavan and Kanthan.<ref name=pmid15967038>{{cite journal |author=Pahlavan PS, Kanthan R |title=Goblet cell carcinoid of the appendix |journal=World J Surg Oncol |volume=3 |issue= |pages=36 |year=2005 |month=June |pmid=15967038 |pmc=1182398 |doi=10.1186/1477-7819-3-36 |url=http://wjso.com/content/3/1/36}}</ref>
*Review of stains in Pahlavan and Kanthan.<ref name=pmid15967038/>


==See also==
==See also==
*[[Vermiform appendix]].
*[[Vermiform appendix]].
*[[Signet ring cell carcinoma]].
*[[Neuroendocrine tumours]].


==References==
==References==
Michael
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