PATHIST HRLM-TEM TEACHING CASES		PATHIST MOAR-MET CASOS DE ENSEÑANZA
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CASE # 1		CASO # 1
WHAT IS YOUR DIAGNOSIS? Identify the numbered structures and try to make a diagnosis. See the answers clicking on LESIONS & DIAGNOSIS.		CUAL ES SU DIAGNOSTICO? Identifique las estrcuturas numeradas y trate de hacer un diagnostico. Vea las respuestas  pulsando sobre LESIONES & DIAGNOSTICO.
Clinical information: This is a biopsy from the small intestine mass from a 36 y old man. HRLM and TEM studies were done from the paraffin sample.		Informacion clinica: Esta biopsia fue tomada de una masa del intestino delgado en un hombre de 36 años. MOAR y MET se hicieron de la mustra en parafina.
Fig 1: Paraffin H&E 400 X		Fig 2: HRLM 800 X
Fig 3: HRLM 800 X		Fig 4: TEM 12000 X
Other tests: Chromogranin positive. Mucin positive.		Otras pruebas: Cromogranina positivo. Mucina positivo.
LESIONS & DIAGNOSIS 1. Neuroendocrine granules. 2. Mucin granules. 3. Tight junctions. 4. Interstitial collagen. DIAGNOSIS: SMALL INTESTINE, ADENOCARCINOID. (MUCINOUS CARCINOID).		LESIONES Y DIAGNOSTICO 1. Gránulos neuroendocrinos. 2. Gránulos de mucina. 3. Zónula occludens. 4. Colágeno intersticial. DIAGNOSTICO: INTESTINO DELGADO. ADENOCARCINOIDE . (Carcinoide mucinoso).
COMMENT: COMMENT: The sample is poorly preserved due to paraffin embedding.		COMENTARIO: La preservacion de la muestra es pobre debido a la inclusion en parafina.
REFERENCES: Yoshinari Mochizuki, Eisuke Takeshima, Yutaka Mizuno, Masahiko Imazawa, Taiji Yamazaki, Kazushige Oda, Yoshihisa Kawase, Tetsuya Yamaoka, Motokazu Takeuchi and Isao Kosugi* A Case of Adenocarcinoid Tumor of the Duodenum Presenting as Duodenal Obstruction. Jpn J Gastroenterol Surg 35: 612-615, 2002 Abstract A 73-year-old woman with abdominal discomfort was found to have a duodenal obstruction, suspected to be due to strongly pancreatitis. Conservative initial therapy was not successful, necessitating exploratory laparotomy. A frozen section of the specimen at the stenotic site was diagnosed as adenocarcinoma and a pylorus-preserving pancreatoduodenectomy was done. Histological findings for the resected specimen showed features of both carcinoid and adenocarcinoma, leading to a diagnosis of adenocarcinoid. Appendiceal adnocarcinoid tumors were common, but a adenocarcinoid tumor arising from the duodenum is very rare. The prognosis of duodenal adenocarcinoid may be postulated to be intermediate between carcinoid and adenocarcinoma, indicating the need for the long-term patient follow-up. Reprint requests Yoshinari Mochizuki Second Department of Surgery, Nagoya University School of Medicine65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560 JAPAN