(range, 13-93 years). Eight patients had carcinoid syndrome (5%) and 1 had Zollinger-Ellison syndrome. Twenty-six percent of tumors were multiple, and 77% were transmurally invasive; 31% had regional lymph node metastases only, and 32% had liver or mesenteric metastases. Ninety-three percent of tumors had an insular growth pattern. Serotonin was expressed in 86% of tumors (86 of 102), chromogranin in 92%, and neuron specific enolase in 95%. Twenty percent of tumors (10 of 51) expressed prostatic acid phosphatase; 96% were argyrophil, and 98% argentaffin. Of 80 cases with follow-up data (mean follow-up, 52 { 5 months), 21% were dead of disease, 16% were dead of other causes, 19% were alive with Presented in part at the meeting of the American disease, and 44% had no evidence of disease at last follow-up. The 5-year Kaplan-
Society of Clinical Pathologists and the CollegeMeier survival estimate for all cases was 58%. By univariate analysis, survival was of American Pathologists, Orlando, Florida, Ocnegatively correlated with distant metastases at the time of surgery (P Å 0.002), tober 1993. mitotic rate (P Å 0.01), tumor multiplicity (P Å 0.01), the presence of carcinoid Rebecca M. Thomas, M.D. was a Callendar-Binsyndrome (P Å 0.02), depth of invasion (P Å 0.03), and female gender (P Å 0.05); ford fellow of the American Registry of Patholby multivariate analysis, survival was negatively associated with distant metastasis ogy at the time this study was conducted.(P Å 0.002), carcinoid syndrome (P Å 0.01), and female gender (P Å 0.03).
CONCLUSIONS. Jejunoileal carcinoid tumors have a relatively high rate of transmu-Current address for Dr. Rebecca Thomas: Deral invasion and aggressive clinical behavior. They are usually insular and largely partment of Pathology, Temple University Hospital, Philadelphia, Pennsylvania.argentaffin, with a high rate of chromogranin and serotonin positivity. These features differentiate jejunoileal carcinoids from other gastrointestinal carcinoids.