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Colon tumor

Carcinoma

Neuroendocrine carcinoma

Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 23 May 2012, last major update May 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● This discussion excludes carcinoid tumors and small cell carcinoma
● Rare; highly aggressive with nodal metastases (Am J Surg Pathol 1990;14:1010, Dis Colon Rectum 2004;47:163)
● Often high stage at diagnosis (Dis Colon Rectum 2004;47:163)
● Mixed neuroendocrine carcinoma-adenocarcinoma also occurs (Virchows Arch 2006;448:644)

Micro description
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● Organoid appearance, larger cells than small cell carcinoma, marked nuclear pleomorphism, large irregular hyperchromatic nuclei with prominent nucleoli, frequent mitotic activity and tumor necrosis

Micro images
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Rectal tumor

       
Concurrent large cell neuroendocrine carcinoma (ulcerative fungating mass) and adenocarcinoma (polypoid mass)

Ampulla of Vater

H&E, chromogranin

Cervix

Trabecular pattern with mitotic activity

Positive stains
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● Cytokeratin, usually EMA, NSE, chromogranin and synaptophysin
● c-kit/CD117 in 23% but not associated with activating mutations (Am J Surg Pathol 2003;27:1551)

Differential diagnosis
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● Focal neuroendocrine cells in adenocarcinoma: more common (Arch Pathol Lab Med 1998;122:912)
● Glandular-neuroendocrine mixed tumor: either composite or collision tumors (Am J Surg Pathol 2011;35:413)

Additional references
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● Korean J Gastroenterol 2006;48:97

End of Colon tumor > Carcinoma > Neuroendocrine carcinoma

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