Liver and intrahepatic bile ducts - tumor

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Liver and intrahepatic bile ducts - tumor

Other malignancies

Neuroendocrine carcinoma

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

General
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● < 100 cases reported; mean age > 40 years, more common in women (Arch Pathol Lab Med 2003;127:1200)
● Normal serum AFP but high serum NSE, chromogranin and synaptophysin levels
● Not associated with chronic liver disease / cirrhosis
● Presents with diarrhea and abdominal pain
● Amphicrine carcinoma: glandular (signet ring morphology, mucicarmine, PASD+, villin+, CDX2+) and neuroendocrine differentiation in same cells (Ann Diagn Pathol 2011;15:355)

Case reports
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● 50 year old man with collision tumor of HCC and high-grade neuroendocrine carcinoma (Virchows Arch 2006;449:376)

Gross description
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● Typically solitary, may be cystic

Micro description
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● Resembles poorly differentiated carcinomas with cellular pleomorphism, nuclear atypia, hyperchromasia and frequent mitotic figures
● May have signet ring morphology with intracytoplasmic vacuoles negative for mucin but positive for neuroendocrine markers (Semin Liver Dis 2010;30:422)

Micro images
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H&E and chromogranin (figures C/D)

H&E and chromogranin (figures C/D)

Positive stains
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● Chromogranin, synaptophysin

Electron microscopy description
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● Dense core granules

Differential diagnosis
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● Carcinoid tumor: low (< 2/10 HPF) mitotic activity, minimal nuclear polymorphism

End of Liver and intrahepatic bile ducts - tumor > Other malignancies > Neuroendocrine carcinoma

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