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Colon tumor


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.


● 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

● 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

Rectal tumor

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

Ampulla of Vater

H&E, chromogranin


Trabecular pattern with mitotic activity

Positive stains

● 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

● 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

Korean J Gastroenterol 2006;48:97

End of Colon tumor > Carcinoma > Neuroendocrine carcinoma

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