Carcinoids of the duodenum. A histologic and immunohistochemical study of 65 tumors.
The light-microscopic and immunohistochemical characteristics of 65 duodenal carcinoids are presented. Most tumors showed a mixture of cribriform, insular, glandular, solid, and trabecular growth patterns. Eighty-five percent of the tumors were argyrophil and 15% argentaffin. The nonspecific neuroendocrine markers chromogranin, Leu-7, and neuron-specific enolase were positive in 97, 91, and 83% of tumors, respectively. Immunoreactivity for specific hormones/amines were as follows (percent positive tumors): somatostatin, 47%; N-gastrin, 56%; serotonin, 39%; calcitonin, 19%; insulin, 5%; pancreatic polypeptide, 3%; adrenal corticotropic hormone, 0%; glucagon, 0%. Sixty-eight percent had gastrin/cholecystokinin-like reactivity. Ten psammomatous tumors were located near the ampulla; eight were somatostatin positive, including two in patients with neurofibromatosis. One additional tumor in a patient with neurofibromatosis lacked psammoma bodies but elaborated somatostatin. Eight additional tumors in nonneurofibromatosis patients produced solely somatostatin. Duodenal carcinoids often elaborate more than one polypeptide hormone; those in the ampulla often elaborate somatostatin and have psammoma bodies.
Burke
A P
AP
Department of Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Federspiel
B H
BH
Sobin
L H
LH
Shekitka
K M
KM
Helwig
E B
EB
D000943:Antigens, Differentiation / Q000032:analysis; D018959:CD57 Antigens; D002116:Calcitonin / Q000032:analysis; D002276:Carcinoid Tumor / Q000032:analysis / Q000473:pathology*; D002864:Chromogranins / Q000032:analysis; D004379:Duodenal Neoplasms / Q000032:analysis / Q000473:pathology*; D005768:Gastrointestinal Hormones / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D010187:Pancreatic Hormones / Q000032:analysis; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D012701:Serotonin / Q000032:analysis; D013004:Somatostatin / Q000032:analysis; D013194:Staining and Labeling
D000943:Antigens, Differentiation; D018959:CD57 Antigens; D002864:Chromogranins; D005768:Gastrointestinal Hormones; D010187:Pancreatic Hormones; D012701:Serotonin; D013004:Somatostatin; D002116:Calcitonin; D010751:Phosphopyruvate Hydratase