Salivary glands - Large cell neuroendocrine carcinoma

Home Chapter Home Jobs Conferences Fellowships Books

Salivary glands

Epithelial / myoepithelial tumors

Large cell neuroendocrine carcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 27 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
=========================================================================

● Extremely rare high grade tumor with neuroendocrine features (organoid, solid, trabecular and rosette-like patterns) and large polygonal cells with coarse chromatin and prominent nucleoli, high mitotic rate, frequent necrosis
● Less than 20 reported cases - must rule out metastatic disease

Clinical features
=========================================================================

● Usually age 60+ years, affects parotid gland
● Aggressive behavior

Case reports
=========================================================================

● 72 and 73 year old men with parotid tumors (Mod Pathol 2000;13:554)
● 74 year old man with parotid mass (Auris Nasus Larynx 2005;32:89)

Treatment
=========================================================================

● Surgery, radiotherapy

Micro description
=========================================================================

● Organoid, solid, trabecular and rosette-like patterns of large polygonal cells with coarse chromatin and prominent nucleoli, high mitotic rate, frequent necrosis

Micro images
=========================================================================

Solid growth of large tumor cells with prominent nucleoli

Organoid growth, peripheral palisading and rosette-like pattern

Neuroendocrine stains and p53

Cytology description
=========================================================================

● Resembles undifferentiatiated carcinoma

Cytology images
=========================================================================

Large, loosely cohesive, pleomorphic tumor cells with prominent nucleoli

Positive stains
=========================================================================

● Neuroendocrine markers (chromogranin, synaptophysin), cytokeratin, p53, BCL2, epidermal growth factor receptor, cyclin D1, Ki-67, CK20

Negative stains
=========================================================================

● Polyoma virus (Am J Surg Pathol 2011;35:1806)

Molecular / cytogenetics description
=========================================================================

● 9p21 LOH and p16 mutation, TP53 LOH and mutation

Electron microscopy images
=========================================================================

Desmosome-like junctions and neurosecretory granules

Differential diagnosis
=========================================================================

● Merkel cell carcinoma: CK20+
● Undifferentiated carcinoma

End of Salivary glands > Epithelial / myoepithelial tumors > Large cell neuroendocrine carcinoma

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).