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A comparative immunohistochemical study of jejunoileal and appendiceal carcinoids. Implications for histogenesis and pathogenesis
Author(s) -
Moyana Terence N.,
Safkunam Nirangala
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19920901)70:5<1081::aid-cncr2820700512>3.0.co;2-9
Subject(s) - chromogranin a , histogenesis , appendix , carcinoid tumors , medicine , gastrin , enterochromaffin cell , pathology , carcinoid tumour , enteroendocrine cell , gastroenterology , endocrine system , carcinoid syndrome , neuroendocrine cell , multiple endocrine neoplasia , immunohistochemistry , serotonin , biology , hormone , paleontology , receptor , secretion , biochemistry , gene
Background . The purpose of this study was to determine the histogenesis of jejunoileal and appendiceal carcinoids and to ascertain whether this could be useful in further explaining the pathology of these neoplasms. Methods . Eight cases each of multiple jejunoileal carcinoids and appendiceal carcinoids together with their respective age‐matched and sex‐matched controls were stained with silver stains, chromogranin A, serotonin, and S‐100. Histomorphometric evaluations of the endocrine cells in the mucosa adjacent to the carcinoids were carried out and compared with the respective controls using the Student's t test. Results . All the carcinoids from both groups stained for argyrophilia, argentaffinity, chromogranin A, and serotonin. Histomorphometric evaluations showed intraepithelial endocrine cell hyperplasia (IECH) in the jejunoileal carcinoid group ( P = 0.007, chromogranin; P = 0.004, serotonin) but not in the appendiceal carcinoid group. On the other hand, subepithelial endocrine cell aggregates that were separate from the main tumor were seen in two cases of appendiceal carcinoids. With S‐100, all appendiceal carcinoids showed intrinsic tumor positivity whereas the jejunoileal carcinoids did not. Conclusions . The finding of IECH with multiple jejunoileal carcinoids suggests that these carcinoids arise from a field effect. The absence of IECH with appendiceal carcinoids as well as their association with subepithelial endocrine cell aggregates and their intimate relationship with Schwann cell processes suggests that appendiceal carcinoids arise from a more discrete unit, the subepithelial neuroendocrine complex.