Diffuse hyperplasia of gastric argyrophil cells and multiple carcinoid tumors. An historical and ultrastructural study.

Abstract

A patient with chronic iron deficiency anemia was shown to have multiple gastric filling defects. These were found to be ulcerated carcinoid tumors. In the partial gastrectomy specimen innumerable carcinoids arose from a unique diffuse hyperplasia of argyrophil cells. Histochemically and ultrastructurally the hyperplastic and neoplastic cells were identical. These cells closely resembled both argyrophil cells from bronchial carcinoid tumors and argyrophil cells in control human stomachs as well as in the gastric mucosa of mice and bats. These cells were compared with those of a carcinoid tumor of the ileum; they appeared to be histochemically and ultrastructurally distinct. This finding is of interest because of the reported differences in the clinical and biochemical features of carcinoids arising in tissue derived from the foregut (bronchus and stomach) as compared with those of midgut derivation (ileum, appendix). The authors suggest that more than one progenitor cell may give rise to carcinoid tumors and that the histochemical and biochemical characteristics of such tumors will depend on the cell of origin.