Terminal ileum carcinoid (well differentiated neuroendocrine tumour)
Presents with obstructive symptoms. The patient underwent a right hemicolectomy.
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- right hemicolectomy photograph includes segment of terminal ileum, caecum and ascending colon with tumour just visible in the distal terminal ileum
- the tumour 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 tumour nodule)
- the tumour forms variably sized, well circumscribed nests ('insular' pattern)
- high power shows
- uniform cells
- rounded nuclei
- granular chromatin (so-called 'salt and pepper' chromatin).
1 case question available
This is good example of a terminal ileal carcinoid, now more commonly referred to as well differentiated neuroendocrine tumour. This lesion was staged as pT3 N1 (with lymph node metastases in 4 of 11 local lymph nodes.
- 1. Levy AD, Sobin LH. From the archives of the AFIP: Gastrointestinal carcinoids: imaging features with clinicopathologic comparison. Radiographics. 27 (1): 237-57. doi:10.1148/rg.271065169 - Pubmed citation