Gastric carcinoid tumors in a brother-sister occurrence, with special reference to ultrastructural features of endocrine granules

Our report concerns gastric carcinoid tumors in a man and his younger sister who had no endocrine symptoms. The tumors in both cases were multiple, located in the corpus, and showed no significant differences in light microscopic and immunohistochemical examination. In electron microscopic observation, the endocrine granules of tumor cells were roughly classified into four types: granules with fine granular content with low electron density, irregularly striped granules with medium electron density, concentrically laminated or regularly striped granules, or smaller and almost uniformly high electron-dense granules in which it was difficult to recognize the internal structure. From the sequential morphological changes of the granules, we have considered that each type of granule reflects various stages of granulogenesis, although the possibility that they are distinct and contain different hormones or chemical mediators is not absolutely ruled out.