Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017, 161(3):281-285 | DOI: 10.5507/bp.2017.027

Are goblet cell carcinoids a group of heterogeneous tumors?

Jirka Macaka,c, Kristina Nemejcovab, Jana Dvorackovaa,c
a Department of Pathology, University of Ostrava and University Hospital Ostrava, Czech Republic
b Department of Pathology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
c CGB Laboratory Inc., Ostrava, Czech Republic

Background: Goblet cell carcinoids belong to neuroendocrine tumors, according to the WHO classification. The tumors are diagnosed based on a typical histological pattern and using neuroendocrine markers. However, some tumors do not react with these markers and yet expression of proliferative markers is high. Do these tumors belong to G1 and G2 neuroendocrine tumors? Methods: The sample comprised nine cases of tumors of the appendix identified by immunohistological methods as goblet cell carcinoids or adenocarcinoma ex goblet cell carcinoid.

Results: In six cases, hematoxylin and eosin staining revealed tumors completely or 90% made of characteristic large tumor cells observed in typical goblet cell carcinoids. The remaining three cases were identified as adenocarcinomas arising ex goblet cell carcinoids. Immunohistological examination revealed that in four cases of typical goblet cell carcinoids, expression of neuroendocrine markers was low or completely negative. Yet in two cases, the Ki-67 proliferative index exceeded the 20% cut-off for inclusion in the G1 and G2 category.

Conclusions: Goblet cell carcinoids are a heterogeneous group of tumors that may express neuroendocrine markers in a small number of tumor cells or are negative to these markers. However, high expression of the proliferative marker Ki-67 exceeds the criteria for G1 and G2 neuroendocrine tumors. It is our opinion that these tumors may be classified as a specific type of carcinoma.

Keywords: goblet cell carcinoid, appendix, immunohistology, negative neuroendocrine markers

Received: January 19, 2017; Accepted: May 19, 2017; Prepublished online: June 12, 2017; Published: September 26, 2017  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Macak, J., Nemejcova, K., & Dvorackova, J. (2017). Are goblet cell carcinoids a group of heterogeneous tumors? Biomedical papers161(3), 281-285. doi: 10.5507/bp.2017.027
Download citation

References

  1. Tang LH, Shia J, Soslow RA, Dhall D, Wong WD, O'Reilly E, Qin J, Paty P, Weiser MR, Guillem J, Temple L, Sobin LH, Klimstra DS. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol 2008;32:1429-43. Go to original source... Go to PubMed...
  2. Lin BT, Gown AM. Mixed carcinoid and adenocarcinoma of the appendix: report of 4 cases with immunohistochemical studies and a review of the literature. Appl Immunohistochem Mol Morphol 2004;12:271-6. Go to original source... Go to PubMed...
  3. McCusker ME, Cote TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer 2002;94:3307-12. Go to original source... Go to PubMed...
  4. Dockerty MB, Ashburn FS. Carcinoid tumors (so-called) of the ileum: report of thirteen cases in which there was metastasis. Arch Surg 1943;47:221-46. Go to original source...
  5. Horn RC Jr. Carcinoid tumors of the colon and rectum. Cancer 1949;2:819-37. Go to original source... Go to PubMed...
  6. Lattes R, Grossi C. Carcinoid tumors of the stomach. Cancer 1956;9:698-711. Go to original source... Go to PubMed...
  7. Gagné F, Fortin P, Dufour V, Delage C. Tumeurs de l'appendice associate des caractères histologiques de carcinoide et d'adénocarcinome. Ann Anat Pathol 1969;14:393-406.
  8. Höfler H, Klöppel G, Heitz PU. Combined production of mucus, amines and peptides by goblet-cell carcinoids of the appendix and ileum. Path Res Pract 1984;178:555-61. Go to original source... Go to PubMed...
  9. Watson PH, Alguacil-Garcia A. Mixed crypt cell carcinoma. A clinicopathological study of the so-called "goblet cell carcinoid". Virchows Archiv A 1987;412:175-82. Go to original source...
  10. Subbuswamy SG, Gibbs NM, Ross CF, Morson BC. Goblet cell carcinoid of the appendix. Cancer 1974;34:338-44. Go to original source... Go to PubMed...
  11. Carr NJ, Sobin LH. Neuroendocrine tumors of the appendix. Semin Diag Pathol 2004;21:108-19. Go to original source...
  12. Gui X, Quin L, Gao ZH, Falck V, Harpaz N. Goblet cell carcinoids at extraappendiceal locations of gastrointestinal tract: an underrecognized diagnostic pitfall. J Surg Oncol 2011;103:790-5. Go to original source... Go to PubMed...
  13. Kanthan R, Saxena A, Kanthan SC. Goblet cell carcinoids of the appendix: immunophenotype and ultrastructural study. Arch Pathol Lab Med 2001;125:386-90. Go to original source...
  14. Edmons P, Merino MJ, LiVolsi V, Duray PH. Adenocarcinoid (mucinous carcinoid) of the appendix. Gastroenterology 1984;86:302-9. Go to original source...
  15. Chetty R, Klimstra DS, Henson DE, Albores-Saavedra J. Combined classical carcinoid and goblet cell carcinoid tumor: A new morphological variant of carcinoid tumor of the appendix. Am J Surg Pathol 2010;34:1163-7. Go to original source... Go to PubMed...
  16. Reid DM, Bastruk O, Shaib WL, Xue Y, Balci S, Choi HJ, Akkas G, Memis B, Robinson BS, El-Rayes BF, Staley CA, Staley CA, Winer JH, Russell MC, Knight JH, Goodman M, Krasinskas AM, Adsay V. Adenocarcinoma ex-goblet carcinoid (appendiceal-type crypt cell adenocarcinoma) is a morphologically distinct entity with highly aggressive behavior and frequent association with peritoneal/intra-abdominal dissemination: an analysis of 77 cases. Mod Pathol 2016;00:1-11. doi:10.1038 modpathol.2016.105 Go to original source... Go to PubMed...
  17. Gallegos NC, Milroy C, Linehan IP, Boulos PB. Crypt cell carcinoma of the appendix. Eur J Surg Oncol 1992;18:386-7.
  18. Isaacson P. Crypt cell carcinoma of the appendix (so-called adenocarcinoma tumor). Am J Surg Pathol 1981;5:213-24. Go to original source... Go to PubMed...
  19. Liu E, Telem DA, Warner RR, Dikman A, Divino M. The role of Ki-67 in predicting biological behavior of goblet cell carcinoid tumor in appendix. Am J Surg 2011;202:400-3. Go to original source... Go to PubMed...
  20. Holt N, Grønbaek H. Goblet cell carcinoids of the appendix. Scientific World Journal 2013;2013:543696. doi:10.1155/2013/543696 Go to original source... Go to PubMed...
  21. Toumpanakis C, Standish RA, Baiehnab MC, Winslet MC, Caplin ME. Goblet cell carcinoid tumors (adenocarcinoid) of the appendix. Dis Colon Rectum 2007;50:315-22. Go to original source... Go to PubMed...
  22. Pericleous M, Lumgair H, Baneke A, Morgan-Rowe L, Caplin ME, Luong TV, Thrilwell C, Gillmore R, Toumpanakis C. Appendiceal goblet cell carcinoid tumour: a case of unexpected lung metastasis. Case Rep Oncol 2012; 5:332-8. Go to original source... Go to PubMed...
  23. O'Dowd G, Gosney JR. Absence of overexpression of p53 protein by intestinal carcinoid tumours. J Pathol 1995;175:403-4. Go to original source... Go to PubMed...
  24. Kabbani W, Houlihan PS, Luthra R, Hamilton SR, Rashid A. Mucinous and nonmucinous appendiceal adenocarcinomas: different clinicopathological features but similar genetic alterations. Mod Pathol 2002;15:599-605. Go to original source... Go to PubMed...
  25. Ramnani DM, Wistuba II, Behrens C, Gazdar AF, Sobin LH, Albores-Saavedra J. K-ras and p53 mutations in the pathogenesis of classical and goblet cell carcinoids of the appendix. Cancer 1999;86:14-21. Go to original source... Go to PubMed...
  26. Stancu M, Wu TT, Wallace C, Houlihan PS, Hamilton SR, Rashid A. Genetic alterations in goblet cell carcinoids of the vermiform appendix and comparison with gastrointestinal carcinoid tumors. Mod Pathol 2003;16:1189-98. Go to original source... Go to PubMed...
  27. van Eeden S, Offerhaus GJA, Hart AA, Boerrigter L, Nederlof PM, Porter E, Velthuysen von M-LF. Goblet cell carcinoid of the appendix: a specific type of carcinoma. Histopathology 2007;51:763-73. Go to original source... Go to PubMed...