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Crypt cell proliferative micronests in rectal carcinoids. An immunohistochemical study
1Department of Pathology, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
The American Journal of Surgical Pathology
|April 1, 1993
Summary
Rectal carcinoids likely originate from localized crypt cell proliferation, not diffuse hyperplasia. These tumors comprise diverse endocrine cells, not a single cell type.
Area of Science:
- Gastroenterology
- Endocrinology
- Oncology
Background:
- Gastrointestinal endocrine cells reside in epithelium and subepithelium, complicating carcinoid histogenesis.
- Gastrointestinal carcinoids are a heterogeneous group with potentially varied origins.
Purpose of the Study:
- Investigate the histogenesis of rectal carcinoids, a poorly understood area.
- Determine the origin of rectal carcinoids in relation to intraepithelial endocrine cells and crypt cells.
Main Methods:
- Examined nine rectal carcinoids and matched controls using silver stains and immunoreagents.
- Quantified intraepithelial endocrine cells per unit length of mucosa.
- Compared carcinoid and control groups using the Student t test.
Main Results:
- No evidence of diffuse intraepithelial endocrine cell hyperplasia was found associated with rectal carcinoids.
- Focal areas of carcinoids abutting the mucosal epithelium were observed in six cases.
- Focal areas of crypt cell proliferative micronests were identified in two cases.
Conclusions:
- Rectal carcinoids appear to arise from localized crypt cell proliferation rather than diffuse intraepithelial endocrine cell hyperplasia.
- Rectal carcinoids likely consist of heterogeneous endocrine cell populations, not a monoclonal origin.