title: Application of light microscopical and ultrastructural immunohistochemistry in the study of goblet cell carcinoid in the appendix.
abstract: BACKGROUND
  Goblet cell carcinoids appear less frequently in the appendix than do other carcinoids. In the presented work a case with a goblet cell carcinoid of the appendix is described.
  
  
  METHODS
  Routine histological and histochemical methods were employed, with a combination of histochemistry and immunohistochemistry on one section and light and electron microscopical immunohistochemisty on paraffin-embedded material, were applied to identify the type of the carcinoid and to reveal the fine structure of cell types in the tumour nests of the appendix.
  
  
  RESULTS
  During the biopsy of a patient who had undergone appendectomy, an infiltration with clusters of goblet cells in the submucosa of the appendix was found. After a second operation of right-sided hemicolectomy, similar clusters of goblet cells were detected in the muscle layers of the caecum. After 18 months the patient died from cirrhosis and had not developed metastases or any recurrence. Immunohistochemically the serotonin-, somatostatin-, chromogranin A- and synaptophysin-positive endocrine cells were basally attached to mucin-secreting cells. The combined staining revealed simultaneously present endocrine cells (chromogranin-A-positive) and mucin-secreting cells (PAS- or alcian blue-positive). The ultrastructural immunohistochemistry showed that chromogranin A-positive cells had discoid and pleomorphic granules and were located in tumour nests or as single cells in the appendiceal wall.
  
  
  CONCLUSIONS
  The combined histochemical and immunohistochemical procedure and the ultrastructural immunohistochemistry on archival material could contribute in clarifying the diagnosis of goblet cell carcinoid.
authors.affiliation: Department of General and Clinical Pathology, Medical Faculty, Trakia University, Stara Zagora, 11 Armeiska Str., Stara Zagora, Bulgaria. mgulubova@hotmail.com
authors.forename: Maya V
authors.initials: MV
authors.lastname: Gulubova
authors.forename: Yovcho
authors.initials: Y
authors.lastname: Yovchev
authors.forename: Tatyana
authors.initials: T
authors.lastname: Vlaykova
authors.forename: Philip
authors.initials: P
authors.lastname: Hadjipetkov
authors.forename: Diana K
authors.initials: DK
authors.lastname: Prangova
authors.forename: Angel
authors.initials: A
authors.lastname: Popharitov
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001063:Appendiceal Neoplasms / Q000175:diagnosis* / Q000628:therapy / Q000648:ultrastructure; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000628:therapy / Q000648:ultrastructure; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007150:Immunohistochemistry; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008853:Microscopy; D008875:Middle Aged
chemical_list: D002955:Leucovorin; D005472:Fluorouracil