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Gastric Carcinoid
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Written by Dr Sebastian Zeki
MCQs for this page
Gastric Carcinoid
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S
olid or
insular (the
most usual
pattern and
especially if
from ECL
cells).
T
rabecular
G
landular
U
ndifferent
-
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 1
Account 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’ carcinoids
These 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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