CARCINOID by Leslie H. Sobin M.D.,
FRCPath Chief
By the shores of Duodenum
where the Villi ply the chyle
Heed Ampulla's tale of Carcinoid
beside the River Bile.
There had come three Pious Patches
from the distant ileal bowel
Most concerned with submucosal
growths
were they fair or foul.
Oh do tell us Great Ampulla
savants say they're Carcinoid
Does it mean we're doomed or is it
something that we can avoid.
So upon the slopes of Oddi
Pious Patches harkened well
To the teachings of Ampulla
as diurnal acid fell.
Now genetically they're endocrine
a tribe diffuse spread wide
From well north of the Pylorus
to the colon's distal side.
They're derived from the
Kulchitsky clan for silver they've attractions
Filled with amines hormones
peptides a rich source of gut reactions.
Tell us why they turn malignant
and a course aimed at aggression
Is it overstimulation
or perhaps gene derepression?
Can they ever be benign
and alike an adenoma
Or are all potential dragons
and akin to carcinoma?
They're most frequent in appendix
where behavior's largely mellow
Filled with serotonin granules
on cut surface brightly yellow.
If they compromise the lumen
the result is suppuration
It's a blessing in disguise
leads to early extirpation.
Woe the Carcinoids of ileum
present when more advanced
Can be into mesenteric fat
their distant spread's enhanced.
Nodules those within the rectum
by palpation are detected
They are typically well localized
and easily resected.
Often having acid phosphatase
and nesting in the wall
Masquerading as prostatic
do avoid this overcall.
In the duodenum there exists
Somatostatinoma
It's a lesion quite distinctive
with small bodies of psammoma.
When anemia is pernicious
then in gastric
wall are grown Tiny carcinoid-like
foci
their potential is unknown.
Gastrinoma lies in pancreas
as far as near the spleen
Causing many peptic ulcers
on the shores of Duode'en.
An appendiceal variety
has goblet cells and mucin
Can be dangerous aggressive
more metastases producing.
Note the Carcinoid's growth
patterns
they're of diagnostic use
You'll find insular trabecular
gland-like and diffuse.
Almost all argyrophilic
about half argentaffin
With an enolase they're positive
dense granules by EM.
Periodically their name is changed
for instance APUDoma
Neuroendocrinic tumor
or Kulchitsky carcinoma.
Although changing names is stylish
it adds little but confusion
Stick to what is widely understood
yes that is my conclusion.
So the Pious Patches back they
sailed
to Ileum's far shore
To the enigmatic carcinoid
and what fate had in store.
The author Leslie H. Sobin M.D., FRCPath Chief
Dr. Sobin serves as
director of the Center for Scientific Publications. About two
thirds of his time is available to the Division of
Gastrointestinal Pathology. Dr. Sobin is associate editor of the
AFIP Atlas of Tumor Pathology, chairman of the TNM/Prognostic
Factors Project of the International Union Against Cancer and
member of the World Health Organization (WHO) Expert Advisory
Panel on Cancer.
Dr. Sobin is professor of
pathology at the Uniformed Services University of the Health
Sciences (USUHS) and adjunct professor of pathology, Georgetown
University Medical College.
www.afip.org/Departments/HepGastr_dept/divgi.html
Please read last section on this page - below.
Thank you, Susan, 1-26-2009
Since
1996 --- when I first located others with
Carcinoid --- I have answered every email sent to me, although some replies were
delayed longer than I liked. I am NO longer able to reply to all e-mails due to
the volume and other things going on in my life (all good). I do love hearing
from others, but an unable to reply to all individually. I shall not forget my
many Carcinoid friends and of course shall reply to you … as time permits. This
web site was 11 years old on April 27, 2008, and my plan is to keep it updated
for many years to come.
Since my husband "retired"
I am away from my computer for days, and sometimes, weeks at a time. Yes, there
is wireless internet and we have tried that a number of places. But, if I deal
with email when we are away from home then it is not a "restful vacation" for
me.
PLEASE
use the SEARCH
capability at the top my pages. You may search for a word, a phrase, a drug, a
treatment, a book title or anything you can think of. You may search this site
only, or search the complete World Wide Web.
To speak with
a person
please know you may call the “telephone information and support line” of the
Carcinoid Cancer Foundation, Inc. (CCF), Tuesday through Thursday 10 a.m. to 4
p.m. Eastern Time at 1-888-722-3132 (free) or 1-914-693-1001. “The
information and support line” is staffed by medical professionals. Mondays and
Fridays are research days, if you call then and do not reach a person do leave a
clear message. The Carcinoid Cancer Foundation’s (CCF) superb web site is at
http://www.carcinoid.org
CCF - Serving
the carcinoid/NETs patient and medical community for close to forty
years (chartered in 1968)
“Meets Extensive Standards of America’s
Most Experienced Charity Evaluator”
Better Business Bureau
DISCLAIMER: I am a patient and NOT a medical
doctor or health care professional. I share information and links to
information that has been helpful to me and that I believe to be correct and
good, but I cannot guarantee the accuracy of this information, except for MY
stories. I urge you not to rely only on this information but I believe
you should discuss your situation and information with your medical doctors
and/or other medical professionals.
"Sunny" Susan Anderson
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