title: Goblet cell carcinoid neoplasm of the appendix: clinical and CT features.
abstract: OBJECTIVE
  To describe the clinical and CT imaging features of goblet cell carcinoid (GCC) neoplasm of the appendix.
  
  
  METHODS
  A computer search of pathology and radiology records over a 19-year period at our two institutions was performed using the search string "goblet". In the patients with appendiceal GCC neoplasms who had abdominopelvic CT, imaging findings were categorized, blinded to gross and surgical description, as: "Appendicitis", "Prominent appendix without peri-appendiceal infiltration", "Mass" or "Normal appendix". The CT appearance was correlated with an accepted pathological classification of: low grade GCC, signet ring cell adenocarcinoma ex, and poorly differentiated adenocarcinoma ex GCC group.
  
  
  RESULTS
  Twenty-seven patients (age range, 28-80 years; mean age, 52 years; 15 female, 12 male) with pathology-proven appendiceal GCC neoplasm had CT scans that were reviewed. Patients presented with acute appendicitis (n=12), abdominal pain not typical for appendicitis (n=14) and incidental finding (n=1). CT imaging showed 9 Appendicitis, 9 Prominent appendices without peri-appendiceal infiltration, 7 Masses and 2 Normal appendices. Appendicitis (8/9) usually correlated with typical low grade GCC on pathology. In contrast, the majority of Masses and Prominent Appendices without peri-appendiceal infiltration were pathologically confirmed to be signet ring cell adenocarcinoma ex GCC. Poorly differentiated adenocarcinoma ex GCC was seen in only a small minority of patients. Hyperattenuation of the appendiceal neoplasm was seen in a majority of cases.
  
  
  CONCLUSIONS
  GCC neoplasm of the appendix should be considered in the differential diagnosis in patients with primary appendiceal malignancy. Our cases demonstrated close correlation between our predefined CT pattern and the pathological classification.
authors.affiliation: Department of Radiology Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. kyungmouklee@alum.mit.edu
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.forename: L H
authors.initials: LH
authors.lastname: Tang
authors.forename: J
authors.initials: J
authors.lastname: Shia
authors.forename: P B
authors.initials: PB
authors.lastname: Paty
authors.forename: M R
authors.initials: MR
authors.lastname: Weiser
authors.forename: J G
authors.initials: JG
authors.lastname: Guillem
authors.forename: L K
authors.initials: LK
authors.lastname: Temple
authors.forename: G M
authors.initials: GM
authors.lastname: Nash
authors.forename: D
authors.initials: D
authors.lastname: Reidy
authors.forename: L
authors.initials: L
authors.lastname: Saltz
authors.forename: M J
authors.initials: MJ
authors.lastname: Gollub
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001063:Appendiceal Neoplasms / Q000000981:diagnostic imaging*; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*