COMPOSITE GLANDULAR-CARCINOID TUMOR OF THE TERMINAL ILEUM

Aims-To investigate a female patient with a tumour mass of the termina l ileum, to define the nature of the tumour, and to correlate its morp hology and behaviour with similar types of tumours of the large intest ine and stomach. Methods-Tissues obtained at colonoscopy, from hemicol ectomy specimens, and from liver and peritoneal biopsy specimens were studied macroscopically, microscopically, histochemically, and immunoh istochemically for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and S100 protein. Resul ts-Macroscopic examination showed a tumour of the terminal ileum protr uding into the caecum. Microscopically the tumour showed two component s, one adenoma with moderate dysplasia and the other carcinoid tumour. The adenomatous component stained positively for EMA and CEA and nega tively for NSE. The carcinoid component stained positively for NSE and negatively for EMA and CEA. Histochemically the carcinoid area was ar gyrophil positive and argentaffin negative. Only the carcinoid had met astasised, to the liver, peritoneum, and the lymph nodes, at the time of diagnosis. Conclusion-The morphological, histochemical, and immunoh istochemical findings confirm the diagnosis of a composite adenoma-car cinoid tumour of the terminal ileum.