Goblet cell carcinoid of appendix: a clinicopathological analysis of two cases

LI Qin-qin; ZHANG Jing; LUO Fang-xiu; YUAN Fei; JIN Xiao-long

doi:10.3969/j.issn.1007-8096.2018.04.005

Abstract：Objective To summarize recent advances in goblet cell carcinoma (GCC)of the appendix,with 2 cases report.Methods Hematoxylin and eosin,AB/PAS mucin and immunohistochemical stains were performed to reveal the histopathologic features and immunohistochemical profile of GCC with review of literature.Results Clinically,Case 1 was 64 year-old male who complained of chronic incomplete intestine obstruction for four months.Case 2 was a 64 year-old femnale who presented with acute appendicitis.Pathologically,both two GCCs were composed of three kinds of neoplastic cells,goblet-like cell,Paneth-like cell,and signet ring-like cell,which arranged in clusters,solid cord,microglands,and rosette-like structure.The two tumors appeared obviously infiltrating whole-layer of appendix wall.The first case also invaded into surrounding tissue,never,blood vessels,and surgical margin.There was obvious signet ring cell carcinoma (more than 50％ of tumor) in Case 1,except the typical GCC component,which consisted with signet ring carcinoma ex GCC diagnostic criteria.Case 2 was diagnosed as a classic GCC.Immunohistochemical stain revealed both goblet-cell and Paneth-like cells expressed synaptophysin,chromnogranin A,CD56,CK 20,CAM5.2,AE1/AE3,and CDX-2.The signet ring cells were positive with cytokeratins;however,no or only weekly reacted with neuroendocrine markers.The follow-up showed the patients were free of the tumor 20 months and 12 months,respectively,after operation.Conclusions GCC is a uniqueentity of NEN showing special clinicopathologic features,immuohistochemical profile,and biologic behavior.7-growth patterns have been described.The mainly differential diagnosis includes mixed adnoneuroendorine carcinoma and primary signet ring cell carcinoma of the appendix.The right hemicolectomy is recommend as standard therapy.