The endocrine cells of the gastrointestinal tract

Argentaffin cells, intestinal metaplasia and antral metaplasia in carcinoma of the gall bladder

The occurrence of argentaffin cells, intestinal metaplasia, and antral metaplasia has been studied in 20 gall bladders with carcinomas, in a papilloma, and in 20 specimens of cholelithiasis. Argentaffin cells were present in six carcinomas, but in only one specimen were they present in large numbers. Only one adenocarcinoma contained occasional argyrophil cells and no argentaffin or argyrophil cells were seen in the papilloma. Five of the 20 specimens of cholelithiasis contained occasional argentaffin cells. Intestinal and antral metaplasia were found in four carcinomas, in the papilloma, and in seven of the 20 specimens of cholelithiasis. It is suggested that metaplastic changes may play a role in the pathogenesis of carcinoma of the gall bladder.

Mucin-producing carcinoid ("composite tumor") of upper third of esophagus: a variant of carcinoid tumor

An unusual upper esophageal polypoid tumor was found to be predominantly a carcinoid tumor and in part a mucin-producing adenocarcinoma. A review of literature showed this to be a unique tumor in this location.

A light and electron microscopic study of an ovarian and rectal carcinoid

An ovarian and rectal carcinoid within the same person is described. The ovarian carcinoid is non-argentaffinic with typical regular granules. The rectal tumour consists of two types of APUD cells, some argentaffinic and diazo-positive, whilst others are non-argyrophilic. These features are mirrored ultrastructurally, some cells containing the large pleomorphic argentaffinic granules while others have smaller regular granules. In addition, focal aggregates of microfilaments were found in both tumour types. These findings are discussed in terms of the APUD concept. The similarities of the APUD tumour cells to D1 APUD cells of the duodenum is highlighted, and an alternative explanation for their derivation is proposed.

The potential value of immunohistologic techniques in the classification of ovarian and testicular tumors

The diagnosis of neoplasia continues to rest upon the judicious application of morphologic criteria for the identification of tumor cells. Immunohistologic techniques offer the pathologist an alternative means of cell identification according to the antigenic constitution of the cell or its products. The potential effect of these techniques upon the diagnosis and classification of neoplasia is illustrated by the application of immunoperoxidase methods to the study of alpha-fetoprotein, human chorionic gonadotrophin, and steroid hormone localization in tumors of the ovary and testis.

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance

We have studied 109 endocrine cell tumours of the gastrointestinal tract, pancreas and bronchus in terms of histological pattern and histochemical staining with immunocytochemical studies on seven tumours. As a result we believe that previous histological classifications need modification. 5-Hydroxytryptamine secreting tumours have a carcinoid (A1) pattern with, in some cases, an additional tubuloacinar element (A1A2) and definable histochemical reactions; well differentiated gastrinomas, insulinomas and glucagonomas are associated commonly, but not exclusively, with particular histological patterns and argyrophilia, but no such association exists for less differentiated tumours. This may be related to the synthesis of precursor hormones by less differentiated tumours. Mixed patterns are common, particularly in tumours of foregut derivation. Prospective studies planned to correlate histology, histochemistry, immunocytochemistry and ultrastructure are needed on all endocrine cell tumours.

The occurrence of argyrophilic and argentaffin cells in the gut of Ciona intestinalis L

Argyrophilic and argentaffin cells occur in the stomach and intestinal epithelium of the sea-squirt, Ciona intestinalis L. These cells are characterized by their basal swelling which contains the nucleus surrounded by small secretory granules and by a filamentous cell-apex which reaches the gut lumen. The cells are scattered unevenly within the epithelium. Their number decreases rapidly towards the lower part of the intestine. The localization, size of granules and their shape are features which differentiate these cells from other secretory cells in the gut epithelium such as mucous cells. These cells are thought to possess an endocrine function.

[The Verner-Morrison syndrome. The clinical picture and pathologic anatomy]

The Verner-Morrison Syndrome is a clinically defined entity caused by an islet cell tumor of the pancreas. More than 60 cases have been described so long. The syndrome is characterized by diarrhea, hypokalemia and hypochlorhydria. In addition to a diabetic disposition, raised calcium levels and skin alterations may be present. The diagnosis is a clinical one. A pancreatic tumor should be searched for and removed. Morphologically a benign and a maligne islet cell tumor or a diffuse hyperplasia of the islets of Langerhans can be found. Until now identification of the tumor cells has not been possible. There seems no doubt that the tumor cells produce a peptide hormone. Secretin, gastric inhibitory polypeptide, vasoactive intestinal polypeptide and combinations of hormones are discussed. The results are contradictory. Theories concerning the formal and causal pathogenesis are only incomplete and unproved up to now.

Immunochemical studies of the endocrine cells of the gastrointestinal tract. I. The use and value of peroxidase-conjugated antibody techniques for the localization of gastrin-containing cells in the human pyloric antrum

This paper describes and immunochemical localization of gastrin-containing endocrine cells in the human pyloric antrum using antibodies conjugated to horseradish peroxidase. With pre-fixed cryostat sections, a distinct clear-cut staining of gastrin-containing cells can be obtained either by direct or indirect single stain procedures, but may cells containing endogenous peroxidase activity also stain. In order to abolish staining due to endogenous peroxidase, sections were pretreated with a number of inhibitors prior to incubation in immune sera, but the inhibitors used appeared to interfere with the antigenicity of the gastrin molecule since subsequent immunochemical localization was impossible. The application of a double-staining technique, however, allowed us to distinguish easily between those cells which contained endogenous peroxidase and those on to which labelled antibody had been adsorbed. No labelled cells were found in post-fixed cryostat sections of fresh-frozen tissue. The technique is of value because preparations are permanent, a fluorescence microscope is not required, and the same technique can be adapted for use with the electron microscope.

ACTH-secreting 'apudoma' of gallbladder

The case of a 44-year-old woman is reported. The diagnosis after the appropriate tests and laparotomy was ACTH-secreting 'apudoma' of the gallbladder. This is a rare tumour and this case is believed to be the first reported of an ectopic hormone producing tumour from this side.