Summary
The clinicopathological features of six appendix and five bowel tumours with features of the so-called ‘goblet cell carcinoid’ are described. By light microscopy, these tumours were composed predominantly of mucous cells, together with variable proportions of endocrine and Paneth cells. Immunohistochemical and ultrastructural study confirmed this impression and no amphicrine cells were seen. The clinical course of all cases arising in the bowel, and three out of six appendix tumours was characterised by an aggressive behaviour with the development of widespread lymphatic and often intraperitoneal metastasis, but liver metastasis occurred in only one instance. We conclude, both from this study and from a review of the literature, that the ‘mixed crypt cell carcinoma’ forms a distinct clinicopathological entity justifying separate classification from adenocarcinoma and carcinoid tumour.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Abt AB, Carter SL (1976) Goblet cell carcinoid of the appendix. Arch Pathol Lab Med 100:301–306
Alenghat E, Okagaki E, Talerman A (1986) Primary mucinous carcinoid of the ovary. Cancer 777–783
Ali MH, Davidson AK, Azzopardi JG (1984) Composite gastric carcinoid and adenocarcinoma. Histopathology 8:529–536
Almagro UA (1983) Primary signet ring carcinoma of the colon. Cancer 52:1453–1457
Arends J, Bosman FT (1983) Signet ring cell carcinoma of rectum. Histopathology 7:135–136
August DA, Sugerbaker PH, Schneider PD (1985) Lymphatic dissemination of hepatic metastases. Implications for the follow-up and treatment of patients with colorectal cancer. Cancer 55:1490–1494
Bak M, Jorgensen LJ (1987) Adenocarcinoid of the appendix presenting with metastases to the liver. Dis Colon Rectum 30:112–115
Bonello JC, Sternberg SS, Quan SHQ (1980) The significance of the signet-cell variety of adenocarcinoma of the rectum. Dis Colon Rectum 23:180–183
Chejfec G, Capella C, Solcia E, Jao W, Gould VE (1985) Amphicrine cells, dysplasias, and neoplasias. Cancer 56:2683–2690
Chen V, Quizilbash AH (1979) Goblet cell carcinoid tumour of the appendix. Report of five cases and review of the literature. Arch Pathol Lab Med 103:180–182
Cheng H, Leblond CP (1974) Origin, differentiation and renewal of the four main epithelial cell types in the mouse small intestine. V. Unitarian theory of the origin of the four epithelial cell types. Am J Anat 141:537–562
Cheng H, Bjerknes M, Amar J (1984) Methods for the determination of epithelial cell kinetic parameters of human colonic epithelium isolated from surgical and biopsy specimens. Gastroenterology 86:78–85
Cooper PH, Warkel RL (1978) Ultrastructure of the goblet cell carcinoid type of adenocarcinoid of the appendix. Cancer 42:2687–2695
Dilawari RA, Douglass HO (1979) Gastrointestinal carcinoids: extrahepatic metastases and symptomatology following resection. J Surg Oncol 11:243–248
Edmonds P, Merino MJ, LiVolsi VA, Duray PH (1984) Adenocarcinoid [mucinous carcinoid] of the appendix. Gastroenterology 86:302–309
Giacchero A, Aste H, Baracchini P, Conio M, Fulcheri E, Lapertosa G, Tanzi R (1985) Primary signet-ring carcinoma of the large bowel. Report of nine cases. Cancer 56:2723–2726
Haqqani MT, Williams G (1977) Mucin producing carcinoid tumours of the vermiform appendix. J Clin Pathol 30:473–480
Heisterberg L, Wahlin A, Neilsen KS (1982) Two cases of goblet cell carcinoid of the appendix with bilateral ovarian metastases. Acta Obstet Gynecol Scand 61:153–156
Hernandez FJ, Reid JD (1969) Mixed carcinoid and mucus-secreting intestinal tumours. Arch Pathol 88:489–495
Hernandez FJ, Fernandez BB (1974) Mucus secreting colonic carcinoid tumours: light and electron microscopic study of three cases. Dis Colon Rectum 17:387–396
Hirshfield LS, Kahn LB, Winkler B, Bochner RZ, Gibstein AA (1985) Adenocarcinoid of the appendix presenting as bilateral Krukenberg's tumour of the ovaries. Immunohistochemical and ultrastructural studies and literature review. Arch Pathol Lab Med 109:930–833
Hofler H, Kloppel G, Heitz PhU (1984) Combined production of mucus, amines and peptides by goblet cell carcinoids of the appendix and ileum. Pathol Res Pract 178:555–561
Isaacson P (1981) Crypt cell carcinoma of the appendix (so-called adenocarcinoid tumour. Am J Surg Pathol 5:213–224
Kirkegaard P, Hjortrup A, Halse C, Luke M, Christiansen J (1981) Long term results of surgery for carcinoid tumours of the gastrointestinal tract. Acta Chir Scand 147:693–695
Klappenbach RS, Kurman RJ, Sinclair CF, James LP (1985) Composite carcinoma-carcinoid tumours of the gastrointestinal tract. A morphologic, histochemical, and immunocytochemical study. Am J Clin Pathol 84:137–143
Klein HZ (1974) Mucinous carcinoid of the vermiform appendix. Cancer 33:770–777
Kochevar J (1984) Adenocarcinoid tumour, goblet cell type, arising in a ureteroileal conduit: a case report. J Urol 131:957–959
Kubo T, Watanabe H (1971) Neoplastic argentaffin cells in gastric and intestinal carcinomas. Cancer 27:447–454
Lui IOL, Kung ITM, Lee JMH, Boey JH (1985) Primary colorectal signet-ring cell carcinoma in young patients: report of 3 cases. Pathology 17:31–35
Lundquist M, Wilander E (1983) Exocrine and endocrine cell differentiation in small intestinal carcinomas. Acta Pathol Microbiol Immunol Scand Set A 91:469–474
Lyss AP, Thompson JJ, Glick JH (1981) Adenocarcinoid tumour of the colon arising in preexisting ulcerative colitis. Cancer 48:833–839
Martensson M, Nobin A, Sundler F (1983) Carcinoid tumours in the gastrointestinal tract- an analysis of 156 cases. Acta Chir Scand 149:607–616
Muto Y, Okamoto K, Uchimura M (1984) Composite tumour (ordinary adenocarcinoma, typical carcinoid, and goblet cell adenocarcinoid) of the gallbladder: a variety of composite tumour. Am J Gastroenterol 79:645–649
Nadel L, Mori K, Shinya H (1983) Primary linitis plastica of the colon and rectum. Dis Colon Rectum 26:738–742
Olssen B, Ljungberg O (1980) Adenocarcinoid of the vermiform appendix. Virchows Arch [A] 386:201–210
Rodriguez FH, Sarma DP, Lundseth JH (1982) Goblet cell carcinoid of the appendix. Hum Pathol 13:286–288
Russel AH, Tong D, Dawson LE, Wisbeck W (1984) Adenocarcinoma of the proximal colon. Sites of initial dissemination and patterns of recurrence following surgery alone. Cancer 53:380–367
Russel AH, Pelton J, Reheis CE, Wisbeck WM, Tong DY, Dawson LE (1985) Adenocarcinoma of the colon: an autopsy study with implications for new therapeutic strategies. Cancer 56:1446–1451
Shousha S (1982) Signet-ring cell adenocarcinoma of rectum: a histological, histochemical and electron microscopic study. Histopathology 6:341–350
Smith DM, Haggitt RC (1984) The prevalence and prognostic significance of argyrophil cells in colorectal adenocarcinomas. Am J Surg Pathol 8:123–128
Soga J, Tazawa K (1971) Pathologic analysis of carcinoids. Histologic reevaluation of 62 cases. Cancer 28:990–998
Subbuswamy SG, Gibbs NM, Morson BC (1974) Goblet cell carcinoid of the appendix. Cancer 34:338–344
Tahara E, Ito H, Nakagami K, Shimamoto F, Yamamoto M, Sumii K (1982) Schirrous argyrophil cell carcinoma of the stomach with multiple production of polypeptide hormones, amine, CEA, lysozyme, and HCG. Cancer 49:1904–1915
Tahara E, Ito H, Shimamoto F, Iwamoto T, Nakagami K, Niimoto H (1982) Lysozyme in human gastric carcinoma: a retrospective immunohistochemical study. Histopathology 6:409–421
Toker C (1969) Observations on the composition of certain colonic tumours. Cancer 24:257–260
Warkel RL, Cooper PH, Helwig EB (1978) Adenocarcinoid, a mucin-producing carcinoid tumour of the appendix. A study of 39 cases. Cancer 42:2781–2793
Warner TFCS, In Sook Seo (1979) Goblet cell carcinoid of the appendix. Ultrastructural features and histogenetic aspects. Cancer 44:1700–1706
Welch JP, Malt RA (1977) Management of carcinoid tumours of the gastrointestinal tract. Surg Gynecol Obstet 145:223–227
Whitehead R, Cosgrove C (1979) Mucins and carcinoid tumours. Pathology 11:473–478
Wolff M (1982) Crypt cell carcinoma. Am J Surg Pathol 6:188–189
Wolff M, Ahmed N (1976) Epithelial neoplasms of the vermiform appendix (exclusive of carcinoid). I. Adenocarcinoma of the appendix. Cancer 37:2493–2510
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Watson, P.H., Alguacil-Garcia, A. Mixed crypt cell carcinoma. Vichows Archiv A Pathol Anat 412, 175–182 (1987). https://doi.org/10.1007/BF00716191
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00716191