3. Carcinoid Tumor of the Rectum

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We examined twenty-four carcinoid tumors of the rectum in twenty-one patients on the histological and histochemical viewpoint. Four of 21 tumors were microcarcinoids incidentally found in the surgical specimens of the rectum resected for familial adenomatosis coli with carcinoma. Twenty-one carcinoids were made up mostly of anastomosing trabecular and ribbonlike structures, partly added by more various structures, and in only three small solid nests or short trabeculae predominated.<BR>All of 21 carcinoids examined histochemically were positive for the silver impregnation on specific secretory granules, that is, 19 tumors for the argyrophil reaction by Grimelius method and 2 for the argentaffin reaction by Fontana method. There were PAS positive granules in the tumor cells in all of 16 tumors examined and alcian blue positive mucus of epithelial type in a few foci in two of 20 tumors examined.<BR>Four microcarcinoids were composed uniformly of nonargentaffin, argyrophil cells sho-wing a trabecular pattern and located in the deep mucosa above the muscularis mucosae. A 0.3 mm microcarcinoid as limited to the deep mucosa, but two 0.7 mm and one 0.8 mm microcarcinoids indicated an early minimal invasion of the submucosa just below the muscularis mucosae. Rectal carcinoids measuring 5 mm and above grew mainly in the submucosa forming a well-circumscribed tumor mass.<BR>Contrary to the former reports, the present results suggest that nearly all of the rectal carcinoids are reactive and positive for silver impregnation on specific secretory granules especially for argyrophil cells by Grimelius method like the foregut-derived carcinoids. Most of the rectal cercinoids seem to be derived from argyrophil cells found in the basiglandular area of the rectal tubules, occasionally accompanying a few mucous cells by divergent differentiation of primitive tumor cells.
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3. Carcinoid Tumor of the Rectum

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