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Urothelial carcinoma-invasive

Large cell neuroendocrine carcinoma

Reviewers: Rugvedita Parakh, M.D., HCG Oncology (see Reviewers page)
Revised: 3 July 2011, last major update June 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.


● Rare, aggressive tumor similar to counterpart in lung
● Combination of histologic (neuroendocrine morphology and necrosis), cytologic (large cell size, abundant cytoplasm, nucleoli, coarse chromatin, high mitotic rate) and imuunohistochemical evidence of neuroendocrine origin
● Distinguished from atypical carcinoid tumor by necrosis and higher mitotic rate

Case reports

● 32 year old man with aggressive tumor (Pathol Int 2006;56:688)
● 73 year old man with aggressive tumor (Mod Pathol 1998;11:1016)
● 82 year old man whose tumor had small adenocarcinoma component (Arch Pathol Lab Med 2002;126:1229)
● Patient with cutaneous metastases (Am J Dermatopathol 2009;31:166)

Micro description

● Resembles lung counterpart (Int J Urol 2008;15:1080)
● Either pure or mixed
● Large polygonal cells with low nuclear to cytoplasmic ratio, coarse chromatin, frequent nucleoli, 10+ mitotic figures/10 HPF, multiple areas of necrosis

Micro images

Various images

Positive stains

● TTF1, Leu7/CD57, NSE
● Variable synaptophysin and chromogranin (Am J Clin Pathol 2007;128:733)


● Atypical cells with rosettes and nuclear molding, fine or coarsely granular chromatin, hyperchromasia
● Average nuclear to cytoplasmic ratio is 1:1.4 (Acta Cytol 2010;54:303)

End of Bladder > Urothelial carcinoma-invasive > Large cell neuroendocrine carcinoma

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