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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 = | | Caption = Goblet cell adenocarcinoma. [[H&E stain]]. | ||
| Synonyms = goblet cell carcinoid (obsolete term), crypt cell carcinoma | |||
| Micro = small clusters of cells with stippled chromatin and a goblet cell-like appearance | | Micro = small clusters of cells with stippled chromatin and a goblet cell-like appearance | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]] | | LMDDx = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]], poorly differentiated adenocarcinoma | ||
| Stains = [[alcian blue stain|alcian blue]] +ve, [[PASD stain|PASD]] +ve, [[mucicarmine stain|mucicarmine]] +ve | | 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 | ||
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| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = "acute appendicitis" | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
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| ClinDDx = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology | | ClinDDx = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology | ||
}} | }} | ||
''' | '''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''',<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- | *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/> | *Usually presents as [[acute appendicitis]].<ref name=pmid15967038/> | ||
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==Gross== | ==Gross== | ||
*Typically no mass is apparent at gross.<ref name=pmid15967038/> | *Typically no mass is apparent at gross.<ref name=pmid15967038/> | ||
Note: | |||
*Should be [[submitted in total]]. | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid15967038 | 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/> | *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 | **DNA: crescentic nucleus (similar to in signet ring cells). | ||
***+/- | ***+/-Multi-nucleation. | ||
***+/-High mitotic rate. | ***+/-High mitotic rate. | ||
***Usually minimal nuclear atypia. | ***Usually minimal [[nuclear atypia]]. | ||
DDx: | DDx: | ||
*[[Appendiceal neuroendocrine tumour]]. | *[[Appendiceal neuroendocrine tumour]]. | ||
*[[Signet ring cell carcinoma]] - cell detached. | *[[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: | Image:Appendix Carcinoid GobletCell HP PA.JPG|Goblet cell carcinoid - high power (SKB) | ||
Image: | 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, | **[[mucicarmine stain|Mucicarmine]], [[PASD stain|periodic acid-Schiff diastase stain]] (PAS-D), [[alcian blue stain|alcian blue]]. | ||
==IHC== | ==IHC== | ||
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**Synaptophysin +ve. | **Synaptophysin +ve. | ||
**Chromogranin +ve. | **Chromogranin +ve. | ||
*S-100 +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: | ||
* | *Review of stains in Pahlavan and Kanthan.<ref name=pmid15967038/> | ||
==See also== | ==See also== |
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