Carcinoid

Question 1

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Appendicular carcinoid detected incidentally found following appendectomy for acute appendicitis (8mm size invading mucosa and muscularis propria).

Q1. What’s carcinoid?

Answer 1

Tumor of neuroendocrine cells and mostly enterochromaffin cell

Question 2

Q2. Where’s it most found?

Answer 2

Small intestine, appendix , lung, rectum, stomach

Question 3

Q3. What’re the methods to diagnose carcinoid?

Answer 3

Blood test; Chromagranine A
Urine; urine 24 hrs 5-HIAA
IHC to confirm chromagranine B

Question 4

Q4. What does it release/ Which hormones are released?

Answer 4

Seritonine,
PG,
hitamines,
Bradykinenes and
Subsctance P

Question 5

Q5. Which cells are involved?

Answer 5

Enterochromafin cells

Question 6

Q6. When does it become symptomatic? Why?

Answer 6

It’s typically asymptomatic at its original site but it become symptomatic when goes into liver. As liver will be damaged and canot metabolize hormons like serotonin and then symptoms start to appear

Question 7

Q7. Signs and symptoms of carcinoid spread?

Answer 7

Periodical abd pain,
diarhea,
malabsorption,
cardiac manifestations,
asthma like symptoms

Question 8

Q8. Most common metastatic site?

Answer 8

Liver

Question 9

Q9. What is immunohistochemistry?

Answer 9

Method to localize certain antigens based on Ag-Ab reaction recognition
it use cytokeratine stains this marker is expressed in SQ.CC not in Adeno
P63, P40 are expressed in Sq.CC not in others.

Question 10

Q10. Procedure of immunohistochemistry? Significance of procedure?

Answer 10

Identify the tissue origins

Question 11

Q11.Which specialty does it?

Answer 11

Clinical pathology

Question 12

Q12: Significance of IHC in carcinoid?

Answer 12

To identify the chromogranine B

Question 13

Q13. Signs and symptoms?
Psaudomemb. Colitis

Answer 13

Bloody stool, Vomiting, Abd pain, fever

Question 14

Q14. Only one test to detect pseudo membranes formed by clostridium

Q.Test to Dx Pseudomembranous colitis?

Answer 14

ELIZA

Question 15

He presented with a liver lesion for which resection done & histopathology report showed granulomas with necrotic core containing adult helminths “enterobius vermicularis”

Q15. What’s enterobius vermicularis?

Answer 15

Type of helminth in group of nematodes

Question 16

Q16. Why this patient need regular iron supplement?

Answer 16

As main storage of iron is in liver and it’s now involved
. Due to helminth itself will cuase iron deficiency anemia

Question 17

Q17. What’s the TNM classification of this tumour?

Answer 17

T1NxMx

Question 18

Q18. What’s the management needed for this tumour?

Answer 18

No futher ttt as peendix has been removed