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Presented by Jonathan Epstein, M.D. and prepared by Kara Judson, M.D.
Case 1: A 50-year-old man was found to have an appendiceal mass which was positive for chromogranin.
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1. Question
Week 235: Case 1
A 50-year-old man was found to have an appendiceal mass which was positive for chromogranin./images/822/82205case11.jpg
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/images/822/82205case14.jpgCorrect
Answer: Goblet cell carcinoid
Histology: Obliterating the appendix is an infiltrative process consisting of nests of tumor cells with signet cell morphology. Cytologically, the cells are relatively bland with enlarged nuclei and a single prominent nucleolus. This tumor was found to infiltrate full thickness through the wall of the appendix and infiltrate into the adjacent cecum. Stains for chromogranin and synaptophysin were strongly positive.
Discussion: Obliterating the appendix is an infiltrative process consisting of nests of tumor cells with signet cell morphology. Cytologically, the cells are relatively bland with enlarged nuclei and a single prominent nucleolus. This tumor was found to infiltrate full thickness through the wall of the appendix and infiltrate into the adjacent cecum. Stains for chromogranin and synaptophysin were strongly positive.
Incorrect
Answer: Goblet cell carcinoid
Histology: Obliterating the appendix is an infiltrative process consisting of nests of tumor cells with signet cell morphology. Cytologically, the cells are relatively bland with enlarged nuclei and a single prominent nucleolus. This tumor was found to infiltrate full thickness through the wall of the appendix and infiltrate into the adjacent cecum. Stains for chromogranin and synaptophysin were strongly positive.
Discussion: Obliterating the appendix is an infiltrative process consisting of nests of tumor cells with signet cell morphology. Cytologically, the cells are relatively bland with enlarged nuclei and a single prominent nucleolus. This tumor was found to infiltrate full thickness through the wall of the appendix and infiltrate into the adjacent cecum. Stains for chromogranin and synaptophysin were strongly positive.
