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Carcinomas of the colon with multidirectional differentiation

Report of two cases and review of the literature

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Summary

Two cases of colonic carcinomas with multidirectional differentiation are presented. Both tumors showed light microscopic and immunohistochemical evidence of areas of adenocarcinomatous, squamous cell carcinomatous, and neuroendocrine differentiation. Only six similar cases have been previously reported. These highly malignant tumors support the recent concept of a multipotential stem cell within the mucosa of the gastrointestinal tract capable of differentiation in several directions.

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References

  1. Bates HR, Belter LF: Composite carcinoid tumor (argentaffinoma-adenocarcinoma) of the colon. Dis Colon Rectum 10:467–470, 1967

    PubMed  Google Scholar 

  2. Chong FK, Graham JH, Madoff IM: Mucin producing carcinoid (“composite tumor”) of upper third of oesophagus: A variant of carcinoid tumor. Cancer 44:1853–1859, 1979

    PubMed  Google Scholar 

  3. Cox WF, Pierce GB: The endodermal origin of the endocrine cells of an adenocarcinoma of the colon of the rat. Cancer 50:1530–1538, 1982

    PubMed  Google Scholar 

  4. Gould VE, Jao W, Chejfec G, Banner BF, Bonomi P: Neuroendocrine carcinomas of the gastrointestinal tract. Semin Diagn Pathol 1:13–18, 1984

    PubMed  Google Scholar 

  5. Hernandez FJ, Fernandez BB: Mucus-secreting colonic carcinoid tumors: Light- and electron-microscopic study of three cases. Dis Colon Rectum 17:387–396, 1974

    PubMed  Google Scholar 

  6. Hernandez FJ, Reid JD: Mixed carcinoid and mucus-secreting intestinal tumors. Arch Pathol 88:488–496, 1969

    Google Scholar 

  7. Isaacson P: Crypt cell carcinoma of the appendix (so called adenocarcinoid tumor). Am J Surg Pathol 5:213–224, 1981

    PubMed  Google Scholar 

  8. Klein H: Mucinous carcinoid tumor of the vermiform appendix. Cancer 33:770–777, 1974

    PubMed  Google Scholar 

  9. Olsson B, Ljungberg O: Adenocarcinoid of the vermiform appendix. Virchows Arch (A) 7:643–651, 1980

    Google Scholar 

  10. Pearse AGE, Polak JM: Neural crest origin of the endocrine polypeptid (APUD) cells of the gastrointestinal tract and pancreas. Gut 12:783–788, 1971

    PubMed  Google Scholar 

  11. Rogers LW, Myrphy RC: Gastric carcinoic and gastric carcinoma: Morphologic correlates of survival. Am J Surg Pathol 3:195–202, 1979

    PubMed  Google Scholar 

  12. Soga J, Tazawa K, Aizawa O, Wada K, Tuto T: Argentaffin cell adenocarcinoma of the stomach: An atypical carcinoid? Cancer 33:999–1003, 1971

    Google Scholar 

  13. Toker C: Observations on the composition of certain colonic tumors. Cancer 24:257–260, 1969

    Google Scholar 

  14. Warner TFCS, Seo IS: Goblet cell carcinoid of appendix: Ultrastructural features and histogenetic aspects. Cancer 44:1700–1706, 1979

    PubMed  Google Scholar 

  15. Knight BK, Hayes MMM: Mixed adenocarcinoma and carcinoid tumour of the colon. S Afr Med J 72:708–710, 1987

    PubMed  Google Scholar 

  16. Klappenbach RS, Kurman RJ, Sinclair CF, James LP: Composite carcinoma-carcinoid tumors of the gastrointestinal tract: A morphologic, histochemical and immunocytochemical study. Am J Clin Pathol 84:137–143, 1985

    PubMed  Google Scholar 

  17. Subbuswamy SG, Gibbs NM, Morson BC: Goblet cell carcinoid of the appendix. Cancer 34:338–343, 1974

    PubMed  Google Scholar 

  18. Lyss AP, Thompson JJ, Gluck JH: Adenocarcinoid tumor of the colon arising in preexisting ulcerative colitis. Cancer 48:833–839, 1981

    PubMed  Google Scholar 

  19. Warkel RL, Cooper PH, Helwing EB: Adenocarcinoid tumor of the appendix: A study of 39 cases. Cancer 42:2781–2793, 1978

    PubMed  Google Scholar 

  20. Gould VE: Neuroendocrinomas and neuroendocrine carcinomas: APUD cell system neoplasms and their aberrant secreting activities. Pathol Annu 12:33–62, 1977

    PubMed  Google Scholar 

  21. Birnbaum W: Squamous cell carcinoma and adenoacanthoma of the colon. JAMA 212:1511–1513, 1970

    PubMed  Google Scholar 

  22. Cerezo L, Alvarez M, Edwards O, Price G: Adenosquamous carcinoma of the colon. Dis Colon Rectum 28:597–603, 1985

    PubMed  Google Scholar 

  23. Comer TP, Beahrs OH, Dockerty MB: Primary squamous-cell carcinoma and adeno-acanthoma of the colon. Cancer 28:1111–1117, 1971

    PubMed  Google Scholar 

  24. Cook CB, Klickstein GD: Adenoacanthomas of the colon. Arch Pathol 65:681–687, 1958

    Google Scholar 

  25. Crissmann JD: Adenosquamous and squamous cell carcinoma of the colon. Am J Surg Pathol 2:47–54, 1978

    PubMed  Google Scholar 

  26. Erasmus LJ, Van Heerden JA, Dahlin DC: Adenoacanthoma of the colon. Dis Colon Rectum 21:196–198, 1978

    PubMed  Google Scholar 

  27. Gaston EA: Squamous-cell carcinoma of the colon and rectum: Report of a case. Dis Colon Rectum 10:435–442, 1967

    PubMed  Google Scholar 

  28. Plenge C: Beitrag Zur Frage der Krebse mit orthsfremdem Epith. Virchows Arch Pathol Anat 264:370–382, 1927

    Google Scholar 

  29. Kontozoblov TE, Moyana TN: Adenosquamous carcinoma of the colon: An immunocytochemical and ultrastructural study. Report of two cases and review of the literature. Dis Colon Rectum 32:716–721, 1989

    PubMed  Google Scholar 

  30. Rubia CA, Collins VP, Berg C: Mixed adenosquamous carcinoma of the caecum: Report of a case and review of the literature. Dis Colon Rectum 24:301–304, 1981

    PubMed  Google Scholar 

  31. Damjanov I, Amenta PS, Bosman FT: Undifferentiated carcinoma of the colon containing exocrine, neuroendocrine and squamous cells. Virchows Arch (A) 401:57–66, 1983

    Google Scholar 

  32. Mills SE, Allen MS, Cohen AR: Small-cell undifferentiated carcinoma of the colon: A clinicopathological study of five cases and their association with colonic adenomas. Am J Surg Pathol 7:643–651, 1983

    PubMed  Google Scholar 

  33. Palvio DJ, Sorensen FB, Klove-Mogensen M: Stem cell carcinoma of the colon and rectum: Report of two cases and review of the literature. Dis Colon Rectum 28:440–445, 1985

    PubMed  Google Scholar 

  34. Peonim V, Thakerngpol K, Pacharee P, Stitnimankarn T: Adenosquamous carcinoma and carcinoidal differentiation of the colon. Cancer 52:1122–1125, 1983

    PubMed  Google Scholar 

  35. Petrelli M, Tetanco E, Reid JD: Carcinoma of the colon with undifferentiated carcinoid and squamous features. Am J Clin Pathol 75:581–584, 1981

    PubMed  Google Scholar 

  36. Prade M, Bognel C, Charpentier P, Gadenne C, Duvillard P: Blue Alcian De Grandi: Association de deux colorations. Arch Anat Cytol Pathol 5:313–314, 1981

    Google Scholar 

  37. Sternberger LA: Enzyme-labeled antibodies.In Immunocytochemistry. LA Sternberger (ed). New York, John Wiley & Sons, 1979, pp 82–103

    Google Scholar 

  38. Taylor CR: Immunoperoxidase techniques. Arch Pathol Lab Med 102:113–121, 1978

    PubMed  Google Scholar 

  39. Almagro VA, Pintar K, Zellmer RB: Squamous metaplasia in colorectal polyps. Cancer 53:2679–2682, 1984

    PubMed  Google Scholar 

  40. Chen KT: Colonic adenomatous polyp with focal squamous metaplasia. Hum Pathol 12:848–849, 1981

    PubMed  Google Scholar 

  41. Cramer SF, Velasco ME, Whitlatch SP, Graney MF: Squamous differentiation in colorectal adenomas. Dis Colon Rectum 29:87–91, 1986

    PubMed  Google Scholar 

  42. Sarlin JG, Mori K: Morules in epithelial tumors of the colon and rectum. Am J Surg Pathol 8:281–285, 1984

    PubMed  Google Scholar 

  43. Steele VE, Netteshelm P: Unstable cellular differentiation in adenosquamous cell carcinoma. J Natl Cancer Inst 67:149–154, 1981

    PubMed  Google Scholar 

  44. Williams GT, Blackshaw AJ, Marson BC: Squamous carcinoma of the colorectum and its genesis. J Pathol 129:139–147, 1979

    PubMed  Google Scholar 

  45. Andrew A: A study of the development relationship between enterochromaffin cells and the neural crest. J Embryol Exp Morphol 11:307–324, 1963

    Google Scholar 

  46. Andrew A: Further evidence that enterochromaffin cells are not derived from the neural crest. J Embryol Exp Morphol 31:589–598, 1974

    PubMed  Google Scholar 

  47. Azzopardi JG, Pollock DJ: Argentaffin and argyrophil cells in gastric carcinoma. J Pathol Bacteriol 86:443–451, 1963

    PubMed  Google Scholar 

  48. Gibbs NH: Incidence and significance of argentaffin and Paneth cells in some tumors of the large intestine. J Clin Pathol 20:826–831, 1967

    PubMed  Google Scholar 

  49. Sidhu GS: The endodermal origin of digestive and respiratory tract APUD cells. Am J Pathol 96:5–20, 1979

    PubMed  Google Scholar 

  50. Chang WWL, Leblond CP: Renewal of the epithelium in the descending colon of the mouse. I. Presence of these cell populations vaculitis-columnar mucosa and argentaffin. Am J Anat 131:73–100, 1971

    PubMed  Google Scholar 

  51. Chang WWL, Leblond CP: Renewal of the epithelium in the descending colon of the mouse. II. Renewal of argentaffin cells. Am J Anat 131:101–109, 1971

    PubMed  Google Scholar 

  52. Cheng H, Leblond CP: Origin, differentiation and renewal of the four main cell types in the mouse small intestine. III. Endocrine cells. Am J Anat 141:503–520, 1974

    PubMed  Google Scholar 

  53. Cheng H, Leblond CP: Origin, differentiation and renewal of the four main cell types in the mouse small intestine. V. Unitarian theory of the origin of the four epithelial cell types. Am J Anat 141:537–562, 1974

    PubMed  Google Scholar 

  54. Gould VE, Memoli VA, Dardi LE: Multidirectional differentiation in human epithelial cancers. J Submicrosc Cytol 13:97–115, 1981

    Google Scholar 

  55. De Lellis RA, Tischler AS, Wolfe HJ: Multidirectional differentiation in neuroendocrine neoplasms. J Histochem Cytochem 32:899–904, 1984

    PubMed  Google Scholar 

  56. Ho KJ, Herrera GA, Jones JM, Alexander BA: Small cell carcinoma of the oesophagus. Hum Pathol 15:460–468, 1984

    PubMed  Google Scholar 

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Novello, P., Duvillard, P., Grandjouan, S. et al. Carcinomas of the colon with multidirectional differentiation. Digest Dis Sci 40, 100–106 (1995). https://doi.org/10.1007/BF02063950

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  • DOI: https://doi.org/10.1007/BF02063950

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