Zusammenfassung
Die Diagnose basiert auf dem Nachweis neuroendokriner Eigenschaften der Tumorzellen (APUD) mit positiver argyrophiler Färbung und Chromogranin A-Immunreaktivität. Die klassischen „Midgut“-Karzinoide enthalten Serotonin und weisen eine positive Silberfärbung (Masson) auf. Andere neuroendokrine immunhistochemische Marker sind die neuronenspezifische Enolase (NSE) und das Synaptophysin. Das biologische Tumorverhalten zeigt eine Abhängigkeit von der Lokalisation des Primärtumors. Appendix-Karzinoide, die die häufigste Tumoren darstellen (30%) und oft zufällig bei der Appendektomie mit einem Durchmesser von < 1 cm gefunden werden, sind selten maligne. Andere Dünndarmkarzinoide weisen eine potentielle Malignität auf und metastasieren vorzugsweise in regionale Lymphknoten und in die Leber. Multiple, synchrone Primärtumoren werden bei 20–30% der Patienten beobachtet. „Foregut“ und „Hindgut“-Karzinoide weisen eine potentielle Malignität auf. Eine Ausnahme bilden die ECLomas der Magenmukosa, die bei ca. 90% der Patienten einen benignen Verlauf aufweisen. Es werden üblicherweise fünf histologische Varianten des Karzinoids beschrieben: glandular, trabekulär, nestförmig, undifferenziert und gemischtförmig. Tumoren mit nestförmigem Wachstumsverhalten sollen einen gutartigeren Verlauf aufweisen als Tumoren mit glandulärem oder undifferenziertem Wachstumsmuster.
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Eriksson, B., Öberg, K. (1995). Neuroendokrine Darm- und Pankreastumoren (Apudome). In: Seeber, S., Schütte, J. (eds) Therapiekonzepte Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10494-1_30
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DOI: https://doi.org/10.1007/978-3-662-10494-1_30
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