The section of
bowel is actually bent or doubled back on itself, effectively creating a
"kink." This is a real common configuration of the gross specimen with
this condition because of the marked degree of fibrosis that comes with this
lesion. Sometimes the local fibrotic reaction around the tumor will
actually lead to bowel obstruction just from the compression. Anyway,
here you can see the tremendous degree of infiltration of the lamina propria,
muscle and even serosal surface by this tumor.
Note the clusters of
regular and monotonous looking small ("fried egg like") cells that make up
this tumor. There may be marked fibrosis at the site of the lesion. This
scarring develops as a result of the hormonal products elaborated by this
tumor, serotonin, bradykinin and so forth. Be sure you know what is meant
by the term "carcinoid syndrome" and the especially the circumstances in
which it will appear. And no it's not just because there's a carcinoid tumor
in the ileum. What urinary test is helpful in diagnosing
this condition?