What are the potential complications of ileal (midgut) carcinoids?
Local - intestinal obstruction and bleeding. Endocrine - carcinoid syndome, carcinoid heart disease, intestinal ischaemia.
- 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).