Horiuchi S, Endo T, Shimoji H, Takahashi H, Mitsuuchi M, Yawata A, Mita H, Yoshida M, Arimura Y, Sakamoto H, Itoh F, Hinoda Y, Imai K, Sasaki K, Sato M
First Department of Internal Medicine, Sapporo Medical University, Japan.
J Gastroenterol. 1998 Aug;33(4):582-7. doi: 10.1007/s005350050138.
We report a case of a 62-year-old woman with goblet cell carcinoid of the appendix. She was admitted to our hospital in September 1994 after the discovery of liver tumors. After admission, a tumor in the right kidney and multiple tumors in the liver were found. She was diagnosed with renal cell cancer and metastasis to the liver and underwent excision of the kidney and enucleation of the largest liver tumor. Histological examination revealed that the liver tumor was a metastatic carcinoid tumor. As carcinoid tumors have frequently been found in the appendix, endoscopic examination was performed and a lesion was found in the appendix by colonoscopy. As predicted, the biopsy specimen was a carcinoid tumor, and she underwent an appendectomy. Histologically, the tumor was a goblet cell carcinoid. Goblet cell carcinoid is a rather rare neoplasm that has the histologic features of both carcinoids and adenocarcinoma. Forty-two cases of goblet cell carcinoid of the appendix have been reported thus far in Japan. However, few were diagnosed via endoscopic examination before surgical operation. We also carried out an immunohistochemical study with anti p53 antibody on the goblet cell carcinoid tumor of the appendix. Most tumor cells were strongly positive, while in three benign carcinoid tumors investigated simultaneously they were negative. These findings suggest that goblet cell carcinoid has an aggressive phenotype compared with benign carcinoid tumors.
我们报告一例62岁患有阑尾杯状细胞类癌的女性病例。1994年9月，她在发现肝脏肿瘤后入住我院。入院后，发现右肾有一个肿瘤以及肝脏有多个肿瘤。她被诊断为肾细胞癌并伴有肝转移，随后接受了肾脏切除及最大肝脏肿瘤的剜除术。组织学检查显示肝脏肿瘤为转移性类癌肿瘤。由于类癌肿瘤在阑尾中较为常见，遂进行了内镜检查，通过结肠镜在阑尾中发现了一个病变。正如所料，活检标本为类癌肿瘤，她接受了阑尾切除术。组织学上，该肿瘤为杯状细胞类癌。杯状细胞类癌是一种相当罕见的肿瘤，具有类癌和腺癌的组织学特征。迄今为止，日本已报道42例阑尾杯状细胞类癌病例。然而，术前通过内镜检查确诊的病例很少。我们还对阑尾杯状细胞类癌肿瘤进行了抗p53抗体的免疫组化研究。大多数肿瘤细胞呈强阳性，而同时检测的3例良性类癌肿瘤细胞呈阴性。这些发现表明，与良性类癌肿瘤相比，杯状细胞类癌具有侵袭性表型。
