Difference between revisions of "Goblet cell adenocarcinoma"

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| Image      = Goblet_cell_carcinoid_-2-_very_high_mag.jpg
| Image      = Goblet_cell_carcinoid_-2-_very_high_mag.jpg
| Width      =
| Width      =
| Caption    = Crypt cell carcinoma. [[H&E stain]].
| Caption    = Goblet cell adenocarcinoma. [[H&E stain]].
| Synonyms  = goblet cell carcinoid (obsolete term), crypt cell carcinoma
| Micro      = small clusters of cells with stippled chromatin and a goblet cell-like appearance
| Micro      = small clusters of cells with stippled chromatin and a goblet cell-like appearance
| Subtypes  =
| Subtypes  =
| LMDDx      = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]]
| LMDDx      = [[signet ring cell carcinoma]], [[appendiceal neuroendocrine tumour]], poorly differentiated adenocarcinoma
| Stains    =
| Stains    = [[alcian blue stain|alcian blue]] +ve, [[PASD stain|PASD]] +ve, [[mucicarmine stain|mucicarmine]] +ve
| IHC        = synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve
| IHC        = synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve
| EM        =
| EM        =
| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      =
| Gross      = usu. no mass apparent
| Grossing  =
| Grossing  =
| Site      = [[vermiform appendix]], elsewhere in the GI tract
| Site      = [[vermiform appendix]], elsewhere in the GI tract
| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx = "acute appendicitis"
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence =
| Prevalence = rare
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  = moderate
| Other      =
| Other      =
| ClinDDx    =
| ClinDDx    = [[acute appendicitis]], other appendiceal tumours, other abdominal pathology
}}
}}
'''Crypt cell carcinoma''', also known as '''goblet cell carcinoid'''<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref><ref>{{Cite journal  | last1 = Pahlavan | first1 = PS. | last2 = Kanthan | first2 = R. | title = Goblet cell carcinoid of the appendix. | journal = World J Surg Oncol | volume = 3 | issue =  | pages = 36 | month = Jun | year = 2005 | doi = 10.1186/1477-7819-3-36 | PMID = 15967038 }}</ref>  
'''Goblet cell adenocarcinoma''' is a rare malignant tumour that is typically seen in the [[vermiform appendix]].<ref>{{cite journal |authors=Kiyosawa N, Koyama M, Miyagawa Y, Kitazawa M, Tokumaru S, Soejima Y |title=Goblet cell adenocarcinoma of the appendix: A case report of three cases |journal=Int J Surg Case Rep |volume=106 |issue= |pages=108229 |date=April 2023 |pmid=37084554 |doi=10.1016/j.ijscr.2023.108229 |url=}}</ref>
and '''[[neuroendocrine tumour]] with goblet cell differentiation''', is a rare malignant tumour that is typically seen in the [[vermiform appendix]].
 
It has gone by a number of different names in the past: '''crypt cell carcinoma''',<ref>{{cite journal |authors=Limaiem F, Omrani S, Hajri M |title=Goblet cell adenocarcinoma of the ascending colon: An underrecognized diagnostic pitfall |journal=Clin Case Rep |volume=11 |issue=1 |pages=e6822 |date=January 2023 |pmid=36654693 |pmc=9834544 |doi=10.1002/ccr3.6822 |url=}}</ref> '''goblet cell carcinoid'''<ref>{{cite journal |authors=Sigley K, Franklin M, Welch S |title=Appendiceal Goblet Cell Adenocarcinoma Case Report and Review of the Literature |journal=Cureus |volume=13 |issue=2 |pages=e13511 |date=February 2021 |pmid=33786220 |pmc=7992912 |doi=10.7759/cureus.13511 |url=}}</ref><ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref><ref name=pmid15967038>{{Cite journal  | last1 = Pahlavan | first1 = PS. | last2 = Kanthan | first2 = R. | title = Goblet cell carcinoid of the appendix. | journal = World J Surg Oncol | volume = 3 | issue =  | pages = 36 | month = Jun | year = 2005 | doi = 10.1186/1477-7819-3-36 | PMID = 15967038 }}</ref>  
and '''[[neuroendocrine tumour]] with goblet cell differentiation'''.


==General==
==General==
*Rare appendiceal tumour that typically has an aggressive course vis-a-vis other appendiceal carcinoids.<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref>
*Rare appendiceal tumour that typically has an aggressive course vis-à-vis [[appendiceal carcinoid]]s.<ref name=pmid18042066>{{cite journal |author=van Eeden S, Offerhaus GJ, Hart AA, ''et al.'' |title=Goblet cell carcinoid of the appendix: a specific type of carcinoma |journal=Histopathology |volume=51 |issue=6 |pages=763–73 |year=2007 |month=December |pmid=18042066 |doi=10.1111/j.1365-2559.2007.02883.x |url=}}</ref>
*Mixed (biphasic) tumour with endocrine and exocrine features.
*Mixed (biphasic) tumour with endocrine and exocrine features.
*Usually presents as [[acute appendicitis]].<ref name=pmid15967038/>
**Less common presentations: appendiceal mass, pain.
*Five year survival in one series: 60-85%.<ref name=pmid15967038/>
==Gross==
*Typically no mass is apparent at gross.<ref name=pmid15967038/>
Note:
*Should be [[submitted in total]].


==Microscopic==
==Microscopic==
Features:<ref name=pmid15967038>{{cite journal |author=Pahlavan PS, Kanthan R |title=Goblet cell carcinoid of the appendix |journal=World J Surg Oncol |volume=3 |issue= |pages=36 |year=2005 |month=June |pmid=15967038 |pmc=1182398 |doi=10.1186/1477-7819-3-36 |url=http://wjso.com/content/3/1/36}}</ref>
Features:<ref name=pmid15967038/>
*Mixed neuroendocrine-nonneuroendocrine tumour;<ref name=pmid17684764>{{cite journal |author=Volante M, Righi L, Asioli S, Bussolati G, Papotti M |title=Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms |journal=Virchows Arch. |volume=451 Suppl 1 |issue= |pages=S61–9 |year=2007 |month=August |pmid=17684764 |doi=10.1007/s00428-007-0447-y |url=}}</ref> features of both ''carcinoid'' and ''adenocarcinoma.<ref name=pmid15967038>PMID 15967038.</ref>
*Mixed neuroendocrine-nonneuroendocrine tumour;<ref name=pmid17684764>{{cite journal |author=Volante M, Righi L, Asioli S, Bussolati G, Papotti M |title=Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms |journal=Virchows Arch. |volume=451 Suppl 1 |issue= |pages=S61–9 |year=2007 |month=August |pmid=17684764 |doi=10.1007/s00428-007-0447-y |url=}}</ref> features of both ''carcinoid'' and ''adenocarcinoma.<ref name=pmid15967038/>
**Archictecture: cells arranged in nests or clusters without a lumen.
**Archictecture: cells arranged in nests or clusters without a lumen.
**Location: deep to the intestinal crypts (crypts of Lieberkühn); usually do not involve the mucosa.
**Location: deep to the intestinal crypts (crypts of Lieberkühn); usually do not involve the mucosa.
**Cytoplasm distended with mucin.
**Cytoplasm distended with mucin.
**DNA: crescentic nucleus (similar to in signet-ring cells).
**DNA: crescentic nucleus (similar to in signet ring cells).
***+/-Multinucleation.
***+/-Multi-nucleation.
***+/-High mitotic rate.
***+/-High mitotic rate.
***Usually minimal nuclear atypia.
***Usually minimal [[nuclear atypia]].


DDx:
DDx:
*[[Appendiceal neuroendocrine tumour]].
*[[Appendiceal neuroendocrine tumour]].
*[[Signet ring cell carcinoma]] - cell detached.
*[[Signet ring cell carcinoma]]<ref name=pmid22933998>{{Cite journal  | last1 = Pericleous | first1 = M. | last2 = Lumgair | first2 = H. | last3 = Baneke | first3 = A. | last4 = Morgan-Rowe | first4 = L. | last5 = E Caplin | first5 = M. | last6 = Luong | first6 = TV. | last7 = Thirlwell | first7 = C. | last8 = Gillmore | first8 = R. | last9 = Toumpanakis | first9 = C. | title = Appendiceal goblet cell carcinoid tumour: a case of unexpected lung metastasis. | journal = Case Rep Oncol | volume = 5 | issue = 2 | pages = 332-8 | month = May | year = 2012 | doi = 000339607 | PMID = 22933998 }}</ref> - cells more detached, no neuroendocrine differentiation.
*Poorly differentiated [[adenocarcinoma]] - see ''[[colorectal carcinoma]]''.


===Images===
===Images===
====Case 1====
<gallery>
Image:Goblet cell carcinoid - low mag.jpg| CCC - low mag. (WC/Nephron)
Image:Goblet cell carcinoid - intermed mag.jpg| CCC - intermed. mag. (WC/Nephron)
Image:Goblet cell carcinoid - high mag.jpg| CCC - high mag. (WC/Nephron)
Image:Goblet cell carcinoid - very high mag.jpg| CCC - very high mag. (WC/Nephron)
</gallery>
<gallery>
Image:Goblet cell carcinoid -2- intermed mag.jpg| CCC - intermed. mag. (WC/Nephron)
Image:Goblet cell carcinoid -2- high mag.jpg| CCC - high mag. (WC/Nephron)
Image:Goblet cell carcinoid -2- very high mag.jpg| CCC - very high mag. (WC/Nephron)
</gallery>
====Case 2====
<gallery>
<gallery>
Image:Goblet_cell_carcinoid_-2-_very_high_mag.jpg | CCC - very high mag. (WC/Nephron)
Image:Appendix Carcinoid GobletCell HP PA.JPG|Goblet cell carcinoid - high power (SKB)
Image:Goblet_cell_carcinoid_-_very_low_mag.jpg | CCC - very low mag. (WC/Nephron)
Image:Appendix Carcinoid GobletCell HP (5) PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell MP PA.JPG|Appendix - Goblet cell carcinoid - medium power (SKB)
Image:Appendix Carcinoid GobletCell HP (4) - Copy PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP (3) - Copy PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP-2 PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
Image:Appendix Carcinoid GobletCell HP-2 (2) PA.JPG|Appendix - Goblet cell carcinoid - high power (SKB)
</gallery>
</gallery>


==Stains==
==Stains==
*Mucin stains +ve:
*Mucin stains +ve:
**Mucicarmine, perodic acid-Schiff diastase (PAS-D), alician blue.
**[[mucicarmine stain|Mucicarmine]], [[PASD stain|periodic acid-Schiff diastase stain]] (PAS-D), [[alcian blue stain|alcian blue]].


===IHC===
==IHC==
*Classic neuroendocrine markers:
*Classic neuroendocrine markers:
**Synaptophysin +ve.
**Synaptophysin +ve.
**Chromogranin +ve.
**Chromogranin +ve.
*S-100 +ve.
*[[S-100]] +ve.
*NSE +ve.
*NSE +ve.
*Serotonin +ve.
*Serotonin +ve.


Keratins:
Keratins:
*Usually CK20 +ve > CK7 +ve.
*Usually [[CK20]] +ve > [[CK7]] +ve.


*CEA +ve (membrane).
*CEA +ve (membrane).


Notes:
Notes:
*Nice review of stains in Pahlavan and Kanthan.<ref name=pmid15967038>{{cite journal |author=Pahlavan PS, Kanthan R |title=Goblet cell carcinoid of the appendix |journal=World J Surg Oncol |volume=3 |issue= |pages=36 |year=2005 |month=June |pmid=15967038 |pmc=1182398 |doi=10.1186/1477-7819-3-36 |url=http://wjso.com/content/3/1/36}}</ref>
*Review of stains in Pahlavan and Kanthan.<ref name=pmid15967038/>


==See also==
==See also==

Latest revision as of 17:53, 27 April 2023

Goblet cell adenocarcinoma
Diagnosis in short

Goblet cell adenocarcinoma. H&E stain.
Synonyms goblet cell carcinoid (obsolete term), crypt cell carcinoma
LM small clusters of cells with stippled chromatin and a goblet cell-like appearance
LM DDx signet ring cell carcinoma, appendiceal neuroendocrine tumour, poorly differentiated adenocarcinoma
Stains alcian blue +ve, PASD +ve, mucicarmine +ve
IHC synaptophysin +ve, chromogranin +ve, S-100 +ve, CK20 +ve
Gross usu. no mass apparent
Site vermiform appendix, elsewhere in the GI tract
Clinical history "acute appendicitis"
Prevalence rare
Prognosis moderate
Clin. DDx acute appendicitis, other appendiceal tumours, other abdominal pathology

Goblet cell adenocarcinoma is a rare malignant tumour that is typically seen in the vermiform appendix.[1]

It has gone by a number of different names in the past: crypt cell carcinoma,[2] goblet cell carcinoid[3][4][5] and neuroendocrine tumour with goblet cell differentiation.

General

  • Rare appendiceal tumour that typically has an aggressive course vis-à-vis appendiceal carcinoids.[4]
  • Mixed (biphasic) tumour with endocrine and exocrine features.
  • Usually presents as acute appendicitis.[5]
    • Less common presentations: appendiceal mass, pain.
  • Five year survival in one series: 60-85%.[5]

Gross

  • Typically no mass is apparent at gross.[5]

Note:

Microscopic

Features:[5]

  • Mixed neuroendocrine-nonneuroendocrine tumour;[6] features of both carcinoid and adenocarcinoma.[5]
    • Archictecture: cells arranged in nests or clusters without a lumen.
    • Location: deep to the intestinal crypts (crypts of Lieberkühn); usually do not involve the mucosa.
    • Cytoplasm distended with mucin.
    • DNA: crescentic nucleus (similar to in signet ring cells).
      • +/-Multi-nucleation.
      • +/-High mitotic rate.
      • Usually minimal nuclear atypia.

DDx:

Images

Case 1

  • CCC - low mag. (WC/Nephron)

  • CCC - intermed. mag. (WC/Nephron)

  • CCC - high mag. (WC/Nephron)

  • CCC - very high mag. (WC/Nephron)

  • CCC - intermed. mag. (WC/Nephron)

  • CCC - high mag. (WC/Nephron)

  • CCC - very high mag. (WC/Nephron)

Case 2

  • Goblet cell carcinoid - high power (SKB)

  • Appendix - Goblet cell carcinoid - high power (SKB)

  • Appendix - Goblet cell carcinoid - medium power (SKB)

  • Appendix - Goblet cell carcinoid - high power (SKB)

  • Appendix - Goblet cell carcinoid - high power (SKB)

  • Appendix - Goblet cell carcinoid - high power (SKB)

  • Appendix - Goblet cell carcinoid - high power (SKB)

Stains

IHC

  • Classic neuroendocrine markers:
    • Synaptophysin +ve.
    • Chromogranin +ve.
  • S-100 +ve.
  • NSE +ve.
  • Serotonin +ve.

Keratins:

  • CEA +ve (membrane).

Notes:

  • Review of stains in Pahlavan and Kanthan.[5]

See also

References

  1. ↑ Kiyosawa N, Koyama M, Miyagawa Y, Kitazawa M, Tokumaru S, Soejima Y (April 2023). "Goblet cell adenocarcinoma of the appendix: A case report of three cases". Int J Surg Case Rep 106: 108229. doi:10.1016/j.ijscr.2023.108229. PMID 37084554.
  2. ↑ Limaiem F, Omrani S, Hajri M (January 2023). "Goblet cell adenocarcinoma of the ascending colon: An underrecognized diagnostic pitfall". Clin Case Rep 11 (1): e6822. doi:10.1002/ccr3.6822. PMC 9834544. PMID 36654693. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834544/.
  3. ↑ Sigley K, Franklin M, Welch S (February 2021). "Appendiceal Goblet Cell Adenocarcinoma Case Report and Review of the Literature". Cureus 13 (2): e13511. doi:10.7759/cureus.13511. PMC 7992912. PMID 33786220. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992912/.
  4. ↑ 4.0 4.1 van Eeden S, Offerhaus GJ, Hart AA, et al. (December 2007). "Goblet cell carcinoid of the appendix: a specific type of carcinoma". Histopathology 51 (6): 763–73. doi:10.1111/j.1365-2559.2007.02883.x. PMID 18042066.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Pahlavan, PS.; Kanthan, R. (Jun 2005). "Goblet cell carcinoid of the appendix.". World J Surg Oncol 3: 36. doi:10.1186/1477-7819-3-36. PMID 15967038.
  6. ↑ Volante M, Righi L, Asioli S, Bussolati G, Papotti M (August 2007). "Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms". Virchows Arch. 451 Suppl 1: S61–9. doi:10.1007/s00428-007-0447-y. PMID 17684764.
  7. ↑ Pericleous, M.; Lumgair, H.; Baneke, A.; Morgan-Rowe, L.; E Caplin, M.; Luong, TV.; Thirlwell, C.; Gillmore, R. et al. (May 2012). "Appendiceal goblet cell carcinoid tumour: a case of unexpected lung metastasis.". Case Rep Oncol 5 (2): 332-8. doi:000339607. PMID 22933998.
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