ARGYROPHIL CELL-CARCINOMA (APUDOMA) OF ESOPHAGUS - HISTOPATHOLOGIC ENTITY

In a series of 79 cases of primary resected esophageal carcinoma, there were 6 tumors with specific histopathologic features valid for the diagnosis of argyrophil cell carcinoma. Of the 6 tumors, 3 were studied by EM and an assay for ACTH content was performed in 4 tumors. The ages of the 6 patients ranged from 56-71 yr; 2 were women and 4 men. Four of the 6 patients died with widespread tumor recurrence within 9 mo of surgery. Microscopically, the 6 tumors were composed largely or almost entirely of small, spindle-shaped cells resembling those of oat cell carcinoma of the lung, and were characterized by the arrangement of tumor cells in solid sheets or anastomosing cords, the presence of argyrophil tumor cells and deposits of amyloid. By EM the 3 tumor contained neurosecretory type grunules. Using bioassay or radioimmunoassay, ACTH activity in the tumor tissue was detected in 2 of the 4-tumors determined. From the light microscopic and EM characteristics and assay evidence, it seems reasonable to conclude that the 6 tumors are endocrin polypeptide producing tumors (apudomas) that arise from argyrophil cells normally found among the basal cells of the esophageal mucosa, and they represent a distinct histopathologic entity distinguishable from other types of esophageal carcinomas.