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Multiple microcarcinoids arising in chronic ulcerative colitis
1Department of Pathology, University of British Columbia, Vancouver General Hospital, Canada.
American Journal of Clinical Pathology
|July 1, 1992
Summary
This study reports multiple, tiny colonic microcarcinoids found in a patient with chronic ulcerative colitis and cancer. These neuroendocrine tumors may originate from dysplastic stem cells in the colon.
Area of Science:
- Gastroenterology
- Gastrointestinal Pathology
- Gastrointestinal Oncology
Background:
- Chronic ulcerative colitis (CUC) is an inflammatory bowel disease associated with an increased risk of colorectal cancer.
- Dysplasia in CUC signifies a premalignant condition, necessitating close monitoring and management.
- Colorectal neuroendocrine tumors (carcinoids) are rare, with distinct clinicopathological features.
Observation:
- A 50-year-old male patient with CUC, dysplasia, and synchronous colorectal carcinomas underwent a total colectomy.
- Microscopic examination of the resected colon revealed multiple, minute ( < 2 mm) microcarcinoids, undetectable by gross inspection.
- These colonic microcarcinoids exhibited histological similarities to gastric microcarcinoids typically seen in pernicious anemia.
Findings:
- Unlike gastric microcarcinoids, the colonic lesions lacked associated endocrine cell hyperplasia in the overlying mucosa.
- The study proposes that these colonic microcarcinoids may have originated from dysplastic stem cells within the colonic crypts.
- This finding suggests a potential novel pathway for neuroendocrine tumor development in the context of chronic colitis-associated dysplasia.
Implications:
- The identification of colonic microcarcinoids in this context expands the understanding of neuroendocrine tumor origins.
- This case highlights the importance of thorough microscopic examination of colectomy specimens in patients with long-standing CUC and dysplasia.
- Further research is warranted to elucidate the precise mechanisms and clinical significance of colonic microcarcinoids arising in dysplastic conditions.