acid-phosphatase and Carcinoid-Tumor

A case of primary carcinoid tumor of the kidney occurring in a 66-year-old woman is reported. The tumor was 10 x 10 x 9 cm in size, solid, yellowish-white in color, and associated with massive hemorrhagic necrosis. Histologically, it was composed of trabecular and anastomosing ribbon-like nests. The tumor cells showed argyrophilicity with the Grimelius stain and cytoplasmic positivity for neuroendocrine markers, (including chromogranin A, neuron-specific enolase, synaptophysin and Leu-7), prostatic acid phosphatase, keratin and vimentin. Numerous cytoplasmic neurosecretory granules were demonstrated ultrastructurally. These histologic and immunohistochemical findings are consistent with the theory that this tumor has a common phenotype with that of carcinoid tumor arising from the hindgut or cloaca.

Topics: Acid Phosphatase; Aged; Anatomy, Cross-Sectional; Carcinoid Tumor; Female; Humans; Immunohistochemistry; Kidney Neoplasms; Microscopy, Electron; Oliguria; Tomography, X-Ray Computed

We report a case of primary renal carcinoid, which is a very rare neoplasm: to our knowledge, only 19 cases have been previously reported. The tumor displayed histologic features typical of carcinoid tumors from other sites, including growth in nests and ribbons, uniform cells with finely granular, eosinophilic cytoplasm, and stippled chromatin. Electron microscopy confirmed the presence of membrane-bound dense-core granules. Immunohistochemical analysis revealed staining for chromogranin A, neuron-specific enolase, Leu-7, and synaptophysin, as well as pancreatic polypeptide. An interesting finding was the positive staining for prostatic acid phosphatase, while staining for prostate-specific antigen was negative. Although prostatic acid phosphatase is commonly seen in primary gastrointestinal hindgut carcinoids, in this case a primary hindgut carcinoid was ruled out by clinical examination and endoscopy. The patient developed metastases to the liver, but was well and without symptoms 15 months after diagnosis.

Topics: Acid Phosphatase; Adult; Antigens, CD; Antigens, Differentiation, T-Lymphocyte; Carcinoid Tumor; CD57 Antigens; Chromogranin A; Chromogranins; Humans; Immunohistochemistry; Kidney Neoplasms; Liver Neoplasms; Male; Pancreatic Polypeptide; Phosphopyruvate Hydratase; Prostate; Prostate-Specific Antigen; Synaptophysin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acid Phosphatase; Adrenal Gland Neoplasms; Alkaline Phosphatase; Amino Acids; Amylases; Bone Neoplasms; Breast Neoplasms; Carcinoid Tumor; Catecholamines; Chorionic Gonadotropin; Clinical Enzyme Tests; Clinical Laboratory Techniques; Female; Glucose-6-Phosphate Isomerase; Humans; Hydroxyindoleacetic Acid; L-Lactate Dehydrogenase; Liver Neoplasms; Male; Neoplasms; Neoplasms, Nerve Tissue; Neuroblastoma; Nucleotidases; Pancreatic Neoplasms; Pheochromocytoma; Pregnancy; Prostatic Neoplasms; Trophoblastic Neoplasms; Vanilmandelic Acid

Prostatic adenocarcinomas commonly exhibit neuroendocrine differentiation as demonstrated by immunohistochemistry. However, true carcinoids of the prostate are rare. We describe herein a case of a primary carcinoid occurring synchronously with a conventional adenocarcinoma in the prostate of a 66-year-old man. The carcinoid measured 0.2 x 0.2 cm and did not show contiguity with adjacent conventional, moderately differentiated adenocarcinoma. Immunohistochemical stains for chromogranin and neuron-specific enolase were strongly immunoreactive in the carcinoid but not in the adenocarcinoma. Both neoplasms demonstrated positive staining for prostatic acid phosphatase and prostate-specific antigen. Owing to the relatively minute size of the carcinoid, the possibility that this tumor will impact negatively on the patient's overall prognosis is not anticipated.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; Biomarkers, Tumor; Carcinoid Tumor; Chromogranin A; Chromogranins; Disease-Free Survival; Humans; Immunoenzyme Techniques; Male; Neoplasms, Multiple Primary; Phosphopyruvate Hydratase; Prostate-Specific Antigen; Prostatic Neoplasms; Protein Tyrosine Phosphatases

Strumal carcinoids (SC) are ovarian tumors containing thyroid parenchyma admixed with carcinoid elements. Microscopically, the carcinoid component of SC usually presents a ribbon or trabecular pattern similar to the pattern exhibited by hindgut carcinoids. The authors designed an immunohistochemical study to ascertain further similarities of the carcinoid component of SC to rectal carcinoids.. Five cases of SC were examined by light microscopic study with hematoxylin and eosin and immunoperoxidase staining with a group of neurohormonal peptides, thyroglobulin, prostatic acid phosphatase, and prostate specific antigen.. All tumors were positive for thyroglobulin, chromogranin, prostatic acid phosphatase (PAP), and glucagon. They were consistently negative for prostate specific antigen and variably positive to the other antibodies.. The consistent positivity of the carcinoid component of SC to PAP immunostaining is a further similarity of these tumors to rectal carcinoids, in which positive immunostaining to PAP has been observed. The similarity is not well understood, however, as all evidence points to the origin of SC from germ cells in mature cystic teratomas without any embryologic relationship to the hindgut.

Topics: Acid Phosphatase; Adolescent; Adult; Carcinoid Tumor; Chromogranins; Cystadenoma; Dermoid Cyst; Female; Glucagon; Humans; Immunoenzyme Techniques; Male; Middle Aged; Ovarian Neoplasms; Pancreatic Polypeptide; Prostate; Serotonin; Struma Ovarii; Thyroglobulin

The immunohistochemical demonstration of prostatic acid phosphatase (PAcP) and/or prostate-specific antigen (PSA) has been accepted as being reliable in identifying metastatic adenocarcinoma of prostate origin. However, islet cell tumors, especially hindgut-derived carcinoid tumors, have occasionally been reported to be positive for PAcP. We therefore studied a series of carcinoid tumors of the lung and gastrointestinal tract immunohistochemically for PAcP expression by using two polyclonal antibodies and one monoclonal antibody. Thirty-three carcinoid tumors were examined. All five rectal carcinoids in the series showed convincing PAcP positivity with at least two of the three anti-PAcP antibodies. No significant PAcP positivity was observed in the remaining 28 foregut- and midgut-derived carcinoid tumors, except for weak focal positivity in one lung carcinoid. PSA antibody reacted negatively in all cases. Western blots of an aqueous cell lysate from one rectal carcinoid revealed protein bands in the region of 45-55 kd that immunoreacted with anti-PAcP antibodies, confirming the validity of the immunostains. These results suggest that PAcP positivity is common in rectal carcinoid tumors and that it most likely represents true PAcP expression. This seemingly aberrant protein expression may be explained by the shared cloacal derivation of the rectum and prostate, giving rise to cells with both endocrine and partial prostatic epithelial differentiation.

Topics: Acid Phosphatase; Adenocarcinoma; Antigens, Neoplasm; Blotting, Western; Carcinoid Tumor; Gastrointestinal Neoplasms; Humans; Immunohistochemistry; Lung Neoplasms; Male; Prostate-Specific Antigen; Rectal Neoplasms; Retrospective Studies

Topics: Acid Phosphatase; Adult; Carcinoid Tumor; Humans; Male; Prostate; Prostatic Neoplasms

We report a case of carcinoid, diagnosed histochemically and biochemically, which was associated with grossly elevated serum prostatic acid phosphatase and normal serum prostate specific antigen.

Topics: Acid Phosphatase; Aged; Carcinoid Tumor; Humans; Immunohistochemistry; Male; Prostate

A series of six ovarian strumal carcinoids was examined. The presence of thyroid follicular epithelium was conclusively proved by the presence of follicular cells immunohistochemically positive for thyroglobulin, and by the ultrastructural identification of non-neuroendocrine cells with features of thyroid epithelium lining the follicles. Progressive replacement of thyroid epithelial cells by carcinoid cells accounts for the predominance of neuroendocrine granule-containing cells and the scarcity of thyroid epithelial cells lining many of the follicles. A variety of neuroendocrine hormones and other immunoreactive substances was demonstrated within carcinoid cells, including somatostatin (five cases), chromogranin (five cases), serotonin (five cases), glucagon (four cases), insulin (two cases), and gastrin (one case). Only one case contained calcitonin-positive cells. None were carcinoembryonic antigen-positive or had amyloid deposits. The carcinoid element in five cases stained positively for prostatic acid phosphatase. While strumal carcinoid shares some features with medullary carcinoma of the thyroid gland, it has sufficient differences to warrant a separate designation.

Topics: Acid Phosphatase; Adult; Aged; Calcitonin; Carcinoid Tumor; Epithelial Cells; Female; Histocytochemistry; Humans; Immunoenzyme Techniques; Middle Aged; Neurosecretory Systems; Ovarian Neoplasms; Struma Ovarii; Thyroglobulin; Thyroid Gland

In a study of 105 gastrointestinal carcinoid tumors, 67% of the rectal carcinoids and 15% of the carcinoids at other gastrointestinal sites were positive, immunohistochemically, for prostatic acid phosphatase activity. These findings are relevant to the differential diagnosis between rectal carcinoids and prostatic carcinoma.

Topics: Acid Phosphatase; Adolescent; Adult; Aged; Carcinoid Tumor; Child; Female; Gastrointestinal Neoplasms; Histocytochemistry; Humans; Immunoenzyme Techniques; Male; Middle Aged; Prostate; Rectal Neoplasms; Staining and Labeling

Although prostate-specific acid phosphatase (PASP) has been recognized as a specific marker of tissue of prostatic origin, several investigators have pointed out that some of the carcinoid tumours and islet cell tumours of the pancreas reacted immunohistochemically to PSAP. We investigated 50 cases immunohistochemically comprising 44 carcinoids of the G-I tract, 3 of the bronchus, 1 each of the ovary, kidney and middle ear. PSAP positive cases were, 30 in G-I tract, one each in ovary and kidney. Eighty percent of tumours of hindgut origin were positive. Apart from the immunohistochemical study, the content of PSAP in preoperative serum and tumour tissue was estimated in a case with a rectal carcinoid. Extremely elevated PSAP was confirmed in both the serum and tumour tissue. Neuroendocrine tumours such as pheochromocytoma, medullary thyroid carcinoma, and islet cell carcinoma were investigated as controls. No cells immunoreactive to PSAP were observed in these control cases. Prostate specific antigen was definitely negative in carcinoids. We would emphasize that PSAP may be an excellent marker of carcinoids especially when derived from hindgut.

Topics: Acid Phosphatase; Adenoma, Islet Cell; Carcinoid Tumor; Female; Gastrointestinal Neoplasms; Humans; Immunoenzyme Techniques; Male; Pheochromocytoma; Prostate; Radioimmunoassay; Rectal Neoplasms; Thyroid Neoplasms

A case of prostatic carcinoid tumor with lymph node metastases is reported. The patient was a 78-year-old male who died in ventricular fibrillation. At autopsy, a 2 X 2 cm, white, irregular tumor was found in the prostate and there were several enlarged para-aortic lymph nodes. Both specimens contained a characteristic carcinoid tumor. Argyrophil stains revealed strong positivity in the primary as well as in the metastatic tumors. Electron micrographs prepared from formalin-fixed tissue demonstrated numerous membrane-bound dense-core granules. Immunoperoxidase-labeled antibodies against both prostatic acid phosphatase and prostate-specific antigen localized in the tumor cells. The ultrastructural and immunohistochemical results support differentiation of the tumor cells toward both prostatic epithelial cells and endocrine cells. We believe that this is the first reported case of a prostatic carcinoid tumor in which specific prostatic tissue markers have been demonstrated in the tumor cells.

Topics: Acid Phosphatase; Aged; Antigens, Neoplasm; Carcinoid Tumor; Humans; Lymphatic Metastasis; Male; Prostate-Specific Antigen; Prostatic Neoplasms

Topics: Acid Phosphatase; Adenoma, Islet Cell; Carcinoid Tumor; Clinical Enzyme Tests; Humans; Male; Prostatic Neoplasms

An unusual case of carcinoma of the prostate with metastases is described. the prostate and the metastases showed adenocarcinoma with carcinoid-like areas. A tumor with the same histologic features was found at the tip of the appendix and proved to be metastatic. The possibility of primary carcinoid of the prostate was considered; however, Fontana-Masson stain and electron microscopy failed to confirm this. Immunoperoxidase stain for prostatic acid phosphatase was done on the prostate and metastases. This stain is specific for tissues of prostatic origin. The stain was positive in the carcinoid-like areas, indicating that it was not a true carcinoid but rather prostatic carcinoma with a carcinoid-like pattern. Apparently, this is the first case of a metastatic prostatic carcinoma showing carcinoid-like areas that were positive for prostatic acid phosphatase.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; Appendiceal Neoplasms; Carcinoid Tumor; Histocytochemistry; Humans; Immunoenzyme Techniques; Male; Prostate; Prostatic Neoplasms

Six patients with liver metastases from carcinoid or colon carcinoma underwent hepatic derterialization. This operation, known to cause both tumor necrosis and liver cell damage, caused considerable increases of several lysosomal acid hydrolases in the circulation. Thus, beta-glucosidase showed a small temporary increase during the operation, followed by a slower but higher reaction reaching a maximum 12 to 36 hours postoperatively. Similar reactions were noted for beta-glucuronidase, acid phosphatase, beta-galactosidase, arylsuphatase A, and N-acetyl-beta-glucosaminidase while no reactions were found for cathepsin D. Very high enzyme levels occurred in a patient dying from bleeding complications in the postoperative period.

Topics: Acid Phosphatase; Aspartate Aminotransferases; Carcinoid Tumor; Cathepsins; Cerebroside-Sulfatase; Glucosidases; Glucuronidase; Hepatic Artery; Humans; Hydrolases; Ligation; Liver; Liver Neoplasms; Neoplasm Metastasis

A case of rectal carcinoid tumor with liver metastases is reported in which a markedly elevated serum acid phosphatase level was found. Tissue assays of the patient's tumor, liver metastasis, and uninvolved liver were performed which demonstrated very high tumor levels of acid phosphatase. The patient also had elevated plasma serotonin levels and urinary 5-hydroxyindole acetic acid levels and did not exhibit the carcinoid syndrome. Autopsy showed no prostate cancer or metastatic bone lesions. Serum acid phosphatase elevation may occur with carcinoid lesions of the rectum.

Topics: Acid Phosphatase; Carcinoid Tumor; Humans; Liver Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Rectal Neoplasms

Topics: Acid Phosphatase; Aged; Biopsy; Breast Neoplasms; Carcinoid Tumor; Castration; Diethylstilbestrol; Humans; Male; Mastectomy; Neoplasm Metastasis; Prostatic Neoplasms; Urination Disorders