Summary
Tumour tissue from a lung cancer patient who showed elevated serum amylase and adrenocorticotropin (ACTH) was studied ultrastructurally, immunohistochemically and biochemically. Histologically the tumour was a small cell carcinoma. On electron microscopic examination the tumour cells contained large zymogen-like granules within the cytoplasm. Furthermore, cells which possessed many small dense core granules of the endocrine type were also observed. It was of interest that the large zymogen-like granule-containing tumour cells had microvilli at the apical border, connected by desmosomes and forming lumina showing adenocarcinomatous differentiation. Electrophoretic analysis of the serum revealed that the major elevated amylase was of the salivary type with minor components. Immunostaining clearly demonstrated that most of the tumour cells possessed immunoreactive ACTH, whereas salivary amylase was only found in occasional clusters of the tumour cells. The results seem to indicate that the tumour showed both endocrine and exocrine characteristics - an amphicrine carcinoma, expressing amylase and ACTH simultaneously.
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Abe K, Adachi I, Miyakawa S, Tanaka M, Yamaguchi K, Tanaka N, Kameya T, Shimosato Y (1977) Production of calcitonin, adrenocorticotropic hormone and melanocyte-stimulating hormone in tumors derived from amine precursor uptake and decarboxylation cells. Cancer Res 37:4190–4194
Abt AB, Carter SL (1976) Goblet cell carcinoid of the appendix. An ultrastructural and histochemical study. Arch Pathol Lab Med 100:301–306
Amman RW, Berk E, Fridhandler L, Ueda M, Wegman W (1973) Hyperamylasemia with carcinoma of the lung. Ann Intern Med 78:521–525
Andrew A (1974) Further evidence that enterochromaffin cells are not derived from the neural crest. J Embryol Exp Morphol 31:589–598
Baylin SB, Mendelsohn G (1980) Ectopic (inappropriate) hormone production by tumors: Mechanisms involved and the biological and clinical implications. Endocrinol Rev 1:45–77
Chejfec G, Capella C, Solcia E, Jao W, Gould VE (1984) Amphicrine carcinomas. Lab Invest 50:10A
Cheng H, Leblond CP (1974) Origin, differentiation and renewal of the four major epithelial cell types in the mouse small intestine. V. Unitarian theory of the origin of the four epithelial cell types. Am J Anat 141:537–562
Cox WF, Pierce GB (1982) The endodermal origin of the endocrine cells of an adenocarcinoma of the colon of the rat. Cancer 50:1530–1538
DeLellis RA, Tischler AS, Wolfe HJ (1984) Multidirectional differentiation in neuroendocrine neoplasms. J Histochem Cytochem 32:899–904
Ende N (1961) Amylase activity in body fluids. Cancer 14:1109–1114
Feyrter F (1938) Über diffuse endokrine epitheliale Organe. Leipzig, JA Barth
Flood TG, Schuerche C, Dorazio RC, Bowers GN (1978) Marked hyperamylasemia associated with carcinoma of lung. Clin Chem 24:1207–1212
Gomi K, Kameya T, Tsumura M, Shimosato Y, Zeze F, Abe K, Yoneyama T (1976) Ultrastructural, histochemical, and biochemical studies of two cases with amylase, ACTH, andβ-MSH producing tumor. Cancer 38:1645–1654
Gould VE (1977) Neuroendocrinomas and neuroendocrine carcinomas. APUD cell system neoplasms and their aberrant secretory activities. Path Ann 12(II):33–62
Gould VE, Linnoila RI, Memoli VA, Warren WH (1983) Neuroendocrine components of the bronchopulmonary tract: hyperplasis, dysplasis and neoplasms. Lab Invest 49:519–537
Hammar S, Sale G (1975) Multiple hormone producing islet cell carcinomas of the pancreas. A morphological and biochemical investigation. Hum Pathol 6:349–362
Heitz PV, Kasper M, Polak JM, Kloppel G (1982) Pancreactic endocrine tumors: immunocytochemical analysis of 125 tumors. Hum Pathol 13:263–271
Isaacson P (1981) Crypt cell carcinoma of the appendix (so-called adenocarcinoid). Am J Surg Pathol 5:213–224
Katayama S, Ikeuchi M, Kanazawa Y, Akanuma Y, Kosaka K, Takeuchi T, Nakayama T (1981) Amylase-producing lung cancer: case report and review of the literature. Cancer 48:2499–2502
Liddle GW, Givens JR, Nicholson WE, Island PP (1965) The ectopic ACTH syndrome. Cancer Res 25:1057–1061
Mepham BL, Frater W, Mitchell BS (1979) The use of proteolytic enzymes to improve Ig staining by the PAP technique. J Histochem 11:345–357
Morohoshi T, Nakamura N, Hayashi K, Kanda M (1980) Amylase producing lung cancer. Electron microscopical and biochemical studies. Virchows Arch [Pathol Anat] 387:125–132
Odell WD, Wolfsen AR (1975) Ectopic hormone secretion by tumors. In: Becker F (ed) Cancer, Plenum Pub Co New York, pp 81
Pearse AGE (1969) The cytochemistry and ultrastructure of polypeptide hormone-producing cells (the APUD series) and embryonic, physiologic and pathologic implications of the concept. J Histochem Cytochem 17:303–313
Otsuki M, Yuu H, Maeda M, Saeki S, Yamasaki T, Baba S (1977) Amylase in the lung cancer. Cancer 39:1656–1663
Reyes CV, Chejfec G, Jao W, Gould VE (1980) Neuroendocrine carcinomas of the esophagus. Ultrastruct Pathol 1:367–376
Sirsat AV, Talardekar RV, Shrikhando SS, Vyas JJ (1976) Serum isoamylase in lung cancer correlation with histological feature of the tumor. Ind J Cancer 13:267–271
Sternburger LA, Hardy PH Jr, Cuculis JJ, Meyer HG (1970) The unlabelled antibody enzyme method of immunohistochernistry. Preparation and properties of soluble antigen antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J Histochem Cytochem 18:315–333
Vuitch MF, Mendelsohn G (1981) Relationship of ectopic ACTH production to tumor differentiation: A morphologic and immunohistochemical study of prostatic carcinoma with Cushing's syndrome. Cancer 47:296–299
Weiss MJ, Edmomdson HA, Wertman M (1951) Elevated serum amylase associated with bronchogenic carcinoma. Am J Cli Pathol 21:1057–1061
Woodard BH, Eisenbarth G, Wallace NR, Mossler JA, McCarty KS Jr (1981) Adrenocorticotropin production by a mammary carcinoma. Cancer 47:1823–1827
Yokoyama M, Natsuizaka T, Ishii Y, Ohshima S, Kasagi A, Tateno S (1977) Amylase-producing lung cancer. Cancer 40:766–772
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Yoshida, Y., Mori, M., Sonoda, T. et al. Ultrastructural, immunohistochemical and biochemical studies on amylase and ACTH producing lung cancer. Vichows Archiv A Pathol Anat 408, 163–172 (1985). https://doi.org/10.1007/BF00707979
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DOI: https://doi.org/10.1007/BF00707979