Terminal ileum carcinoid - well differentiated neuroendocrine tumor (pathology)

Case contributed by Dr Andrew Ryan

Presentation

Presents with obstructive symptoms. The patient underwent a right hemicolectomy.

Patient Data

Age: 60 years
Gender: Female

Macroscopic:

  • right hemicolectomy photograph includes segment of terminal ileum, cecum and ascending colon with tumor just visible in the distal terminal ileum
  • the tumor is
    • 18 mm in diameter 
    • mucosally based
    • pale, homogeneous 
    • shows extension into subserosal tissue (Nb the muscularis propria is invaded rather than destroyed and is seen as a 'C' shaped band of tissue within the tumor nodule)  

Histology:

  • the tumor forms variably sized, well circumscribed nests ('insular' pattern) 
  • high power shows 
    • uniform cells
    • rounded nuclei
    • granular chromatin (so-called 'salt and pepper' chromatin). 

Case Discussion

This is good example of a terminal ileal carcinoid, now more commonly referred to as well differentiated neuroendocrine tumor. This lesion was staged as pT3 N1 (with lymph node metastases in 4 of 11 local lymph nodes.

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Case information

rID: 16308
Published: 9th Jan 2012
Last edited: 13th Aug 2019
Inclusion in quiz mode: Excluded

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