Mixed crypt cell carcinoma. A clinicopathological study of the so-called 'goblet cell carcinoid'.

The clinicopathological features of six appendix and five bowel tumours with features of the so-called 'goblet cell carcinoid' are described. By light microscopy, these tumours were composed predominantly of mucous cells, together with variable proportions of endocrine and Paneth cells. Immunohistochemical and ultrastructural study confirmed this impression and no amphicrine cells were seen. The clinical course of all cases arising in the bowel, and three out of six appendix tumours was characterised by an aggressive behaviour with the development of widespread lymphatic and often intraperitoneal metastasis, but liver metastasis occurred in only one instance. We conclude, both from this study and from a review of the literature, that the 'mixed crypt cell carcinoma' forms a distinct clinicopathological entity justifying separate classification from adenocarcinoma and carcinoid tumour.