Research

Application of light microscopical and ultrastructural immunohistochemistry in the study of goblet cell carcinoid in the appendix

Maya V Gulubova¹ , Yovcho Yovchev² , Tatyana Vlaykova³ , Philip Hadjipetkov² , Diana K Prangova¹ and Angel Popharitov²

¹Department of General and Clinical Pathology, Medical Faculty, Trakia University, Stara Zagora, 11 Armeiska Str., Stara Zagora, Bulgaria

²Department of General Surgery, Medical Faculty, Trakia University, Stara Zagora, Bulgaria

³Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, Stara Zagora, Bulgaria

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World Journal of Surgical Oncology 2008, 6:15doi:10.1186/1477-7819-6-15

Published:	6 February 2008

Abstract

Background

Goblet cell carcinoids appear less frequently in the appendix than do other carcinoids. In the presented work a case with a goblet cell carcinoid of the appendix is described.

Methods

Routine histological and histochemical methods were employed, with a combination of histochemistry and immunohistochemistry on one section and light and electron microscopical immunohistochemisty on paraffin-embedded material, were applied to identify the type of the carcinoid and to reveal the fine structure of cell types in the tumour nests of the appendix.

Results

During the biopsy of a patient who had undergone appendectomy, an infiltration with clusters of goblet cells in the submucosa of the appendix was found. After a second operation of right-sided hemicolectomy, similar clusters of goblet cells were detected in the muscle layers of the caecum. After 18 months the patient died from cirrhosis and had not developed metastases or any recurrence. Immunohistochemically the serotonin-, somatostatin-, chromogranin A- and synaptophysin-positive endocrine cells were basally attached to mucin-secreting cells. The combined staining revealed simultaneously present endocrine cells (chromogranin-A-positive) and mucin-secreting cells (PAS- or alcian blue-positive). The ultrastructural immunohistochemistry showed that chromogranin A-positive cells had discoid and pleomorphic granules and were located in tumour nests or as single cells in the appendiceal wall.

Conclusion

The combined histochemical and immunohistochemical procedure and the ultrastructural immunohistochemistry on archival material could contribute in clarifying the diagnosis of goblet cell carcinoid.