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home - Stomach - Gastric Polyps and Masses - Gastric Carcinoid Written by Dr Sebastian Zeki

Gastric Carcinoid

Solid or insular (the most usual pattern and especially if from ECL cells). Trabecular Glandular Undifferent-ated, or diffuse Chromogranin and/or synaptophysin positive Diagnosis: Histology and immunohistochemistry for chromogranin and/or synaptophysin. Histological Types Cytology: Oval-shaped cells with Oval nuclei with characteristic stippled/speckled chromatin pattern. Carcinoids assoc. with Zollinger-Ellison syndrome or PA can get hyperplastic or dysplastic endocrine growths in the adjacent gastric mucosa. Type 2 (<5% of gastric carcinoids) ECL <1 cm Associated with chronic atrophic gastritis. Sometimes multiple May appear as polypoid lesions with a small central ulcera-tion Chronic gastritis Achlorhydria Antral gastrin hyperplasia Hypergastrinaemia Reflex endocrine cell hyperplasia of the gastric corpus Composed of well-differentiated enterochromaffin-like (ECL) cells.Usually find hyperplastic/ dysplastic changes Type 1Account for 75 % of all gastric carcinoids.It is more common in females.The average age of onset is 60.Patients are usually asymptomatic.Indolent/ Mets are rare (< 2 % of tumours > 2 cm).Survival is excellent. Type 3 ‘Sporadic’ carcinoidsThese account for15-20% carcinoids.It has no associated conditions.As a rule, neither hypergastrinemia or gastrin-dependent ECL cell hyperplasia are present in this condition.These are the most aggressive- 65% have local or hepatic mets.Contain a variety of endocrine cells and are associated with the carcinoid syndrome. 2. Hi levels of gastrin 3. Hypertrophic, hypersecretory gastropathy 4. Well-differentiated ECL type tumors 1. Associated with Zollinger-Ellison syndrome MEN type 1. 5. Intermediate aggressiveness.Only a small propor-tion metastasize Also get ECL hyperplasia and dysplasia in the adjacent gastric mucosa. Gastric Carcinoids Written by Dr Sebastian Zeki

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