[Malignant carcinoid of the duodenum with polymorphism of the neuroendocrine granules].

In a man of 67, malignant multihormonal carcinoid of the duodenum 1 or 2 cm in size with deep penetration into the intestinal wall and multiple metastases into the lymph nodes became a cause of a secondary biliary liver cirrhosis and fatal intestinal haemorrhage. There was a difference between the cell population of a primary tumour in which D-cells dominated and EC-cells were also present and metastasis where a higher level of serotonin and its analogs was detected and where EC-cells dominated and ECL-cells were found as well. This observation confirms the opinion that the malignancy of carcinoid is determined by the degree of its invasiveness. Polymorphism of secretory granules in the cells of the same tumour supports the concept of the unique precursor of APUD-cells.