Lundqvist M, Wilander E
Cancer. 1987 Jul 15;60(2):201-6. doi: 10.1002/1097-0142(19870715)60:2<201::aid-cncr2820600214>3.0.co;2-2.
A specimen from the small intestine with multiple (three) classic carcinoid tumors and one appendiceal carcinoid tumor displaying argentaffinity, argyrophilia (Grimelius stain), and serotonin and neuron specific enolase immunoreactivity was examined by light microscopy with regard to the tumor cell histopathogenesis. The smallest tumor (diameter 0.5 cm) from the small intestine was cut into 512 and the appendiceal tumor into 511 serial sections, which were stained with the argyrophil technique. In the small intestine an increased number of endocrine cells and small proliferating aggregates of endocrine cells were observed among nonendocrine enterocytes in the crypts of Lieberkühn. They seemed to grow initially inside the crypts and to later infiltrate through the basement membrane into the lamina propria of the mucosa. This finding suggests that classic carcinoid tumors of the small intestine develop from mucosal endocrine (enterochromaffin) cells. Since proliferating argentaffin cells were also seen in the mucosal crypts in one of the other two carcinoid tumors (2 cm in diameter) in the same intestine specimen, it is suggested that when multiple carcinoid tumors occur in the small intestine they arise from multiple sites. There was no apparent connection between the mucosal crypts and the carcinoid tumor of the appendix. Thus in this particular case, the appendiceal carcinoid tumor did not appear to derive from the mucosal endocrine cells but from the subepithelial endocrine cells that are present in the lamina propria and submucosa of the appendix wall. Supporting this view is the fact that S-100 protein immunoreactive cells are found both in close relation to subepithelial endocrine cells and as an integral component of appendiceal carcinoid tumors.
对一份来自小肠的标本进行了光镜检查，以研究肿瘤细胞的组织发病机制。该标本中有多个（三个）典型类癌肿瘤和一个阑尾类癌肿瘤，这些肿瘤均显示嗜银性、亲银性（格里米乌斯染色）以及血清素和神经元特异性烯醇化酶免疫反应性。将来自小肠的最小肿瘤（直径0.5厘米）切成512个连续切片，将阑尾肿瘤切成511个连续切片，并用亲银技术进行染色。在小肠中，在利伯kühn隐窝的非内分泌肠上皮细胞之间观察到内分泌细胞数量增加以及内分泌细胞的小增殖聚集体。它们似乎最初在隐窝内生长，随后通过基底膜浸润到黏膜固有层。这一发现表明小肠的典型类癌肿瘤起源于黏膜内分泌（肠嗜铬）细胞。由于在同一小肠标本中的另外两个类癌肿瘤（直径2厘米）之一的黏膜隐窝中也发现了增殖的嗜银细胞，因此提示当小肠出现多个类癌肿瘤时，它们起源于多个部位。阑尾的黏膜隐窝与类癌肿瘤之间没有明显联系。因此，在这个特定病例中，阑尾类癌肿瘤似乎并非起源于黏膜内分泌细胞，而是起源于阑尾壁固有层和黏膜下层中存在的上皮下内分泌细胞。支持这一观点的事实是，在与上皮下内分泌细胞密切相关的部位以及阑尾类癌肿瘤的组成部分中都发现了S - 100蛋白免疫反应性细胞。
