喉頭披裂部カルチノイドの一生検例

Abstract

A 74-year-old housewife consulted with dyspnea of almost 1 year duration. She had neither dyspnea, hemoptoe, nor hoarsness. Her physical examinations including X ray shadows revealed no abnormality. A nodular tumor was detected to be extending from the left arytenoid in laryngoscopy. There were no palpable lymph nodes in the cervical regions, and neither tumor nor ulcer in the esophageal mucosa. A biopsy specimen revealed carcinoid tumor in the arytenoid. The patient did not show so-called carcinoid syndromes. The excised tumor,0.6 x 0.6 X 0.3 cm, was gray white and somewhat nodular. Microscopically, the tumor cells were located within the submucosa beneath the histologically normal, surface-covering squamous epithelium. They were fairly small, uniform-sized cells with scanty cytoplasm, and arranged in nodular and/or acinar structures. Few mitotic figures could be seen. In the cytoplasms of tumor cells, argentaffin reaction was negative and argyrophilic stain was positive. Ultrastructurally, the nuclei exhibited irregular shapes with prominent nucleoli but no obvious chromatin condensation at their margins. Many of the uniform-sized (200-300 nm in diameter), electron-opaque granules with clear halo and limiting membrane, which were similar to the neurosecretory granules in the carcinoid tumor or the oat cell carcinoma of the lung, were found in the cytoplasms. Carcinoid of the arytenoid has never been described in the literatures. Only 1 case of laryngeal carcinoid,14 cases of tracheal carcinoid and 2 cases of esopahgeal carcinoid have been reported. Oat call carcinoma has been described in 6 tracheas and 7 esophagi.