Gallbladder - Small cell carcinoma

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Gallbladder

Malignant gallbladder tumors

Small cell carcinoma

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 15 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Rare high grade neuroendocrine carcinoma resembling tumor of lung
● Mean age 69 years, slight female predominance
● 75% had local extension or metastasis at surgery
● 50% had other coexisting neoplasms, usually adenocarcinoma (Am J Surg Pathol 2001;25:595)
● Mean survival 11 months, range 3-25 months, 10 year survival is zero (Ann Diagn Pathol 2009;13:378)
● No systemic endocrine symptoms

Case reports
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● 54 year old woman with a history of HIV/AIDS (Gastrointest Cancer Res 2011;4:135)

Gross description
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● Mean 3 cm

Micro description
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● Sheets of small cells with hyperchromatic nuclei, finely stippled chromatin, inconspicuous nucleoli, nuclear molding, Azzopardi phenomenon (basophilic staining of blood vessel walls by DNA deposition), scant cytoplasm
● May have minor component of tumor cells in trabeculae, nests or ribbons
● Frequent mitotic activity, necrosis and apoptosis
● Invasion of muscularis propria and perimuscular connective tissue in 90%

Micro images
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H&E, pRB, p16

High N/C ratio, high mitotic rate, nuclear molding, and negative RB staining in tumor cells compared to intact staining in adjacent endothelial cells

Cytology images
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Small round malignant cells

Positive stains
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● AE1-AE3, CAM5.2, chromogranin, NSE, Leu7/CD57, CEA (25%)

Electron microscopy description
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● Dense core secretory granules

Molecular description
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● p53 (75%), p16 INK4a (33%), K-ras codon 12 abnormalities (17%)
● No DPC4 mutations

End of Gallbladder > Malignant gallbladder tumors > Small cell carcinoma

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