gastrins and Uterine-Neoplasms

Histopathological and experimental observations indicate that tumors composed wholly or in part of neuroendocrine elements may arise in tissues derived from ectoderm (including neuroectoderm), mesoderm, and endoderm. These tumors frequently exhibit multidirectional differentiation as manifested by multihormonality and by the presence of morphological features indicative of divergent differentiation both in vivo and in vitro. The existence of stem cells, plasticity of differentiated cells, microenvironmental influences, and random events are factors which might all interact to determine the characteristics of any particular tumor. The production of characteristic regulatory peptide products in association with tumors of specific histological subtypes and with other neuroendocrine markers suggests mechanisms for nonrandom activation of multiple genes common to neuroendocrine-programmed cells. Future studies applying new molecular biological techniques to intact tissues and to in vitro models may help to clarify the mechanisms that regulate the expression of the neuroendocrine phenotype in normal and neoplastic states.

Topics: Adrenal Gland Neoplasms; Animals; Apudoma; Calcitonin; Carcinoid Tumor; Cricetinae; Female; Gastrins; Hormones, Ectopic; Humans; Neurotensin; Ovarian Neoplasms; Pancreatic Neoplasms; Pheochromocytoma; Rats; Somatostatin; Thyroid Neoplasms; Uterine Neoplasms; Vasoactive Intestinal Peptide

Carcinoid is a rare gastrointestinal tumor, with an incidence varying from 1 to 2.5 per 100,000 in the general population. In this article, we report an elevated incidence of carcinoid tumor in an obese population, showing the importance of performing an endoscopic procedure before bariatric surgery.

Topics: Adult; Bariatric Surgery; Carcinoid Tumor; Duodenal Neoplasms; Endoscopy, Digestive System; Female; Gastrectomy; Gastrins; Hepatectomy; Humans; Hysterectomy; Incidental Findings; Liver Neoplasms; Male; Middle Aged; Obesity, Morbid; Preoperative Care; Stomach Neoplasms; Uterine Neoplasms; White People

The concomitant occurrence of neuropeptide-reactive endometrial carcinoma and ileal carcinoid tumor represents an observation that has been unreported until now. We have seen two patients with this rare combination of tumors. The endometrial carcinomas in these cases manifested focal immunoreactivity for neuron-specific enolase; in addition, one contained rare cells showing positive staining for gastrin, and the other displayed focal content of substance P. The carcinoid tumors seen in each case demonstrated immunocytochemical positivity for neuron-specific enolase and vasoactive intestinal polypeptide, and one also exhibited immunoreactivity for gastrin. Whether this association of neoplasms represents a syndromic complex or a coincidence is a matter of speculation at present.

Topics: Aged; Carcinoid Tumor; Female; Gastrins; Histocytochemistry; Humans; Ileal Neoplasms; Nerve Tissue Proteins; Substance P; Uterine Neoplasms

Sixty-eight endometrial carcinomas were examined histochemically and immunohistochemically for the presence of amine-containing or neurohormonal peptide-containing cells, particularly in relation to argyrophil cells. Argyrophil cells, detected in 43 of the 68 endometrial carcinomas by the Grimelius method, were subgrouped into two types according to the distribution of argyrophil granules and the shape of the tumor cells. Type I was found in 7 tumors and type II in 39; 3 tumors contained both cell types. The argyrophilia of type II cells was diminished in varying degrees in some tumors by diastase digestion, although it was unchanged in type I argyrophil cells. Indoleamine was detected by the formaldehyde-induced fluorescence method in type I argyrophil cells of four carcinomas. Immunohistochemically, somatostatin-reactive cells were found in two well-differentiated adenocarcinomas with argyrophilia; many of these cells corresponded to some of the type I argyrophil cells, although some were non-argyrophilic. Two adenosquamous cell carcinomas with type II argyrophil cells also contained cells that were immunoreactive with antisera against gastrin; however, they were non-argyrophilic.

Topics: Adenocarcinoma; Adult; Carcinoma, Squamous Cell; Enterochromaffin Cells; Female; Fluorescence; Gastrins; Histocytochemistry; Hormones; Humans; Immunoenzyme Techniques; Middle Aged; Somatostatin; Uterine Neoplasms

A primary endometrial adenocarcinoma is reported that showed abundant foci suggestive of pathologically differentiated intestinal epithelium. The tumor epithelium was composed of four main cell types. Columnar cells resembled absorptive intestinal cells and displayed glycocalyceal carcinoembryonic antigen immunostaining; mucin-producing cells and a few Paneth-like lysozyme-rich cells were irregularly distributed; a massive quantity of argyrophil cells including a few amphicrine (muco-argyrophil) ones, were detected by Grimelius-Alcian blue method. Immunocytochemical evidence was obtained for the storage of serotonin, somatostatin and gastrin/cholecystokinin in some of the endocrine cells. These findings suggest that the tumor arose from a pluripotential stem cell of the glandular epithelium.

Topics: Adenocarcinoma; Aged; Cholecystokinin; Female; Gastrins; Histocytochemistry; Humans; Immunochemistry; Somatostatin; Uterine Neoplasms