Neuroendocrine neoplasms arising in inflammatory bowel disease: A report of 14 cases

被引:0
作者
Sigel, JE [1 ]
Goldblum, JR [1 ]
机构
[1] Cleveland Clin Fdn, Dept Pathol Anat, Cleveland, OH 44195 USA
关键词
carcinoid tumor; Crohn's disease; inflammatory bowel disease; neuroendocrine tumor; small cell carcinoma; ulcerative colitis;
D O I
暂无
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), is a premalignant condition, because these patients are at increased risk of adenocarcinoma. Neuroendocrine neoplasms (NENs) have rarely been described in this setting. We evaluated 14 cases of NEN arising in a setting of IBD. All of the tumors arose in areas involved by IBD, and all showed immunohistochemical or ultrastructural evidence of neuroendocrine differentiation. The cohort included seven men and seven women (range, 28-71 yr; median, 43 yr). Eight patients had Crohn's disease (CD), and six had UC. Duration of disease ranged from 4 months to 50 years (median, 15 yr), with one of unknown duration. Of the eight patients with CD, five had ileocolitis, one had ileitis, one had colitis, and in one case, the extent of disease was unknown. Of the six patients with UC, four had extensive UC, one had left-sided UC, and the extent of UC tvas unknown in one case. Reasons for surgery included CD complications (five patients), refractory disease (three patients), dysplasia/carcinoma (five patients), and incontinence (one patient). The NENs were well differentiated in 11 cases and poorly differentiated mixed adenocarcinoma/small cell carcinomas in 3 cases. Tumor sites included the rectum (six cases), appendix (four cases), small bowel (two cases), and sigmoid colon (two cases). High-grade dysplasia was present in adjacent mucosa in four cases, and low-grade dysplasia was present in distant mucosa in two cases. Two patients with poorly differentiated NENs died from the disease at 3 and 11 months after tumor excision. All of the other patients were alive without tumor as of last follow-up. We concluded that NENs rarely arise in a setting of IBD. Most are well-differentiated tumors and are clinically indolent. Dysplasia is found in adjacent mucosa in more than one-third of cases, suggesting that neuroendocrine differentiation might evolve from multipotential cells in dysplastic epithelium.
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页码:537 / 542
页数:6
相关论文
共 39 条
  • [1] BARKI Y, 1981, J CAN ASSOC RADIOL, V32, P136
  • [2] Risk and natural history of colonic neoplasia in patients with primacy sclerosing cholangitis and ulcerative colitis
    Brentnall, TA
    Haggitt, RC
    Rabinovitch, PS
    Kimmey, MB
    Bronner, MP
    Levine, DS
    Kowdley, KV
    Stevens, AC
    Crispin, DA
    Emond, M
    Rubin, CE
    [J]. GASTROENTEROLOGY, 1996, 110 (02) : 331 - 338
  • [3] THE COEXISTENCE OF CARCINOID-TUMOR AND CROHNS-DISEASE
    BROWN, GA
    KOLLIN, J
    RAJAN, RK
    [J]. JOURNAL OF CLINICAL GASTROENTEROLOGY, 1986, 8 (03) : 286 - 289
  • [4] SMALL-CELL CARCINOMAS OF THE LARGE-INTESTINE
    BURKE, AB
    SHEKITKA, KM
    SOBIN, LH
    [J]. AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 1991, 95 (03) : 315 - 321
  • [5] DEVROEDE GJ, 1972, CAN J SURG, V15, P369
  • [6] CHRONIC ULCERATIVE-COLITIS COMPLICATED BY ATYPICAL CARCINOID-TUMOR
    DODD, SM
    [J]. JOURNAL OF CLINICAL PATHOLOGY, 1986, 39 (08) : 913 - 916
  • [7] ULCERATIVE-COLITIS AND COLORECTAL-CANCER - A POPULATION-BASED STUDY
    EKBOM, A
    HELMICK, C
    ZACK, M
    ADAMI, HO
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (18) : 1228 - 1233
  • [8] CARCINOID-TUMOR COMPLICATING ULCERATIVE-COLITIS
    FARR, CM
    RAJALA, WP
    [J]. GASTROINTESTINAL ENDOSCOPY, 1990, 36 (03) : 315 - 316
  • [9] FELDMAN C, 1980, INT SURG, V65, P63
  • [10] ULCERATIVE-COLITIS AND CROHNS-DISEASE - A COMPARISON OF THE COLORECTAL-CANCER RISK IN EXTENSIVE COLITIS
    GILLEN, CD
    WALMSLEY, RS
    PRIOR, P
    ANDREWS, HA
    ALLAN, RN
    [J]. GUT, 1994, 35 (11) : 1590 - 1592