Figure 2
Images are from two patients (a–c (one patient) and d–f (another patient]), each with multiple tumor patterns. (a) ‘Poorly cohesive goblet cell pattern’ with non-gland forming, diffusely infiltrative pattern of stromal invasion by goblet-type cells in a manner akin to ‘poorly cohesive cell’ carcinoma. (b) These tumor cells have voluminous cytoplasm containing more basophilic mucin unlike the pale, acidophilic (foveolar-like) mucin more frequently seen in gastric signet ring cell carcinoma. (c) Within the same patient tumor cells showed a ‘Goblet cell carcinoid pattern with high-grade morphology’ characterized by ill-defined acini with marked nuclear enlargement, pleomorphism and hyperchromasia. (d) ‘Poorly cohesive non-mucinous cell pattern’ is composed of small, non-mucinous cells distributed as thin, diffusely infiltrative cords. (e) Note the focus of ‘ordinary carcinoid-like pattern (well-differentiated neuroendocrine tumor)’ with nested/trabecular growth on the right and the more solid goblet cell carcinoid tumor clusters with isolated goblet cells on the left. (f) The same tumor (shown in d and e) also showed a ‘microglandular pattern’ composed of polarized cuboidal-columnar cells forming small, punched-out, rosette-like tubules with interspersed goblet-type cells.
