Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study.
BACKGROUND
Enterochromaffinlike (ECL) cell carcinoids recently observed in rats stimulated new interest in gastric endocrine tumors arising in humans.


METHODS
Paraffin-embedded sections of 55 endocrine tumor cases were stained with H&E, mucin tests were performed, and immunoperoxidase was used for detecting endocrine markers; 23 cases were also investigated ultrastructurally.


RESULTS
Forty-five argyrophil carcinoids, 9 neuroendocrine carcinomas, and 1 gastrinoma were identified. Three clinicopathologic subtypes of carcinoids were characterized: (1) twenty-eight cases, none metastatic, arose in a background of body-fundus atrophic gastritis and hypergastrinemia; (2) seven cases, 2 locally metastatic, were associated with hypertrophic gastropathy and hypergastrinemia due to multiple endocrine neoplasia/Zollinger-Ellison syndrome; and (3) ten were sporadic cases, 7 of which were deeply invasive, 6 metastatic, and 5 histologically atypical. All carcinoids showed histochemical and ultrastructural patterns of ECL cells. The 9 neuroendocrine carcinomas, all deeply invasive and metastatic, were composed of anaplastic, small- to intermediate-sized cells with high mitotic index and focal necrosis.


CONCLUSIONS
Gastrin-promoted carcinoids represent a benign or low grade tumor disease, whereas sporadic carcinoids and neuroendocrine carcinomas are life-threatening neoplasms, independent of gastrin promotion.
Rindi
G
G
Department of Human Pathology, First Faculty of Medicine, University of Pavia, Italy.
Luinetti
O
O
Cornaggia
M
M
Capella
C
C
Solcia
E
E
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000032:analysis; D002276:Carcinoid Tumor / Q000145:classification / Q000473:pathology* / Q000648:ultrastructure; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D005260:Female; D005755:Gastrins / Q000032:analysis; D015292:Glycoprotein Hormones, alpha Subunit / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D007150:Immunohistochemistry; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis; D008854:Microscopy, Electron; D008875:Middle Aged; D018396:Mucin-1; D009377:Multiple Endocrine Neoplasia / Q000145:classification / Q000473:pathology* / Q000648:ultrastructure; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010191:Pancreatic Polypeptide / Q000032:analysis; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D012701:Serotonin / Q000032:analysis; D013004:Somatostatin / Q000032:analysis; D013274:Stomach Neoplasms / Q000145:classification / Q000473:pathology* / Q000648:ultrastructure; D013869:Thiolester Hydrolases / Q000032:analysis; D043222:Ubiquitin Thiolesterase
D000951:Antigens, Neoplasm; D015415:Biomarkers; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D005755:Gastrins; D015292:Glycoprotein Hormones, alpha Subunit; D008562:Membrane Glycoproteins; D018396:Mucin-1; D012701:Serotonin; D013004:Somatostatin; D010191:Pancreatic Polypeptide; D013869:Thiolester Hydrolases; D043222:Ubiquitin Thiolesterase; D010751:Phosphopyruvate Hydratase