Occasionally typical argentaffin (Kultschitzky) cell or so-called "carcinoid " tumours have been described in the human gall-bladder (Joel, 1929;Porter and Whelan, 1939; Bosse, 1943), although I have found no mention in textbooks of histology or pathology of the presence of such cells in the mucosa. There is, however, one case report (Kerr and Lendrum, 1936) of a papilloma of this organ covered with intestinal epithelium containing both Paneth and argentaffin cells. I propose to describe three cases in which the latter type was present.
Materia and MethodsThe material was obtained from operation cases in which extra sections were cut from routine formalin-fixed paraffin blocks and stained by an alkaline silver method, either that of Masson and Hamperl as described by Jacobson (1939) or Gomori's (1948) Nicholson demonstrated how these tubular mucous glands change their type in a high proportion of cases and assume all the structural characters of gastric glands identical with those of the pylorus or those of Brunner. His Fig. 6 confirms this finding and presents a very similar picture to that seen in numerous areas in each of the three cases described below. Seventeen of Nicholson's series of 24 gall-bladders which contained mucous glands possessed those of the gastric type as well in varying numbers and in all stages of differentiation. He analysed the changes that eventually end in the formation of such gastric glands in the gall-bladder and considered that they were of two kinds, namely, regressive, leading to the production of tubular mucous glands and other changes characteristic of the intestines, and progressive, culminating in the production of typical glands of the gastric type. (He considered Brunner's glands to be of the gastric type.)As Nicholson has given such a full description of the changes in the gall-bladder epithelium in chronic inflammatory lesions, it only remains for me to demonstrate that argentaffin cells also occur both in the high columnar epithelium covering the surface of the mucous membrane and in the glandular acini. Morphologically the cells are almost always conical with a broad base in contact with the basement membrane and tapering towards a narrow elongated apex, which usually falls short of the lumen of the gland or the free mucosal surface as the case may be. The nucleus is usually situated near the middle of the cell and is vesicular with chromatin aggregations often more or less evenly distributed beneath the nuclear membrane ( Fig. 3): such a nuclear pattern has been beautifully depicted by Ciaccio (1906). The intracellular granules lie between the nucleus and the basement membrane, that is, they are infranuclear. The histological appearances of these on 10 May 2018 by guest. Protected by copyright.
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