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Typical goblet cell carcinoid of the appendix vermiformis. Severe acute ulcerophlegmonous and purulent appendicitis with occult perforation and fibrinopurulent serositis.
Vermiform Appendix
Haematoxylin & Eosin (H&E)
58 years
58-year old male patient with acute appendicitis.
Appendix with clusters of well-formed goblet cells without cytologic atypia. Infiltration of these cells through the wall into the subserosa can be appreciated. Mitoses are not present in conventional histology. In addition an acute ulcerophlegmonous appendicitis with occult perforation and fibrinopurulent serositis can be seen.
The immunohistochemical stains for neuroendocrine markers (Chromogranin A, Synaptophysin and CD56) reveal cells with neuroendocrine differentiation between the goblet cells.
Goblet cell carcinoid tumors are a rare mixed endocrine-exocrine neoplasm, almost exclusively seen in the appendix. Their biological behavior is intermediate between a classic carcinoid tumor and a conventional adenocarcinoma. Appendical goblet cell carcinoid tumors can be stratified into 3 histological subgroups: Group A: Typical goblet cell carcinoid. Group B: Adenocarcinoid ex goblet cell carcinoid, signet ring cell type. Group C: Adenocarcinoid ex goblet cell carcinoid, poorly differentiated carcinoma type. This classification has an impact on determining the prognosis and guiding the management of patients.
Hanlin L. Wang, MD, PhD and Deepti Dhall, MD. Goblet or Singet Ring Cells- That is the Question. Adv Anat Pathol 2009;16:247254
Andrea Bodmer, University of Basel
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