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Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 10 December 2011, last major update November 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.


● Most abundant synaptic vesicle membrane glycoprotein, present in neuronal presynaptic vesicles
● Gene is at Xp11.23-p11.22
● May regulate endocytosis to ensure vesicle availability during and after sustained neuronal activity (Neuron 2011;70:847)
● Specific, but not sensitive for neuroendocrine tumors
● More sensitive in well differentiated tumors
● Granular cytoplasmic pattern in small cell carcinoma reflects neurosecretory granules

Uses by Pathologists

● Common neuroendocrine marker (also chromogranin and CD56)

Micro images

Adrenal gland: left-corticomedullary mixed tumor, middle-adrenocortical adenoma, right-adrenocortical carcinoma

Bladder: left-paraganglioma, middle-small cell carcinoma, right-mixed small cell / urothelial carcinoma

Bladder: small cell carcinoma (cytology)

Breast: colloid carcinoma

Breast: neuroendocrine carcinoma (left 2 images), neuroendocrine DCIS (right 2 images)

CNS: left-chordoma, right-gangliocytoma

Colonic polyp - tubulovillous adenoma with microcarcinoids

Colon: small cell carcinoma (fig D)

Esophagus: small cell carcinoma

Kidney: carcinoid tumor (cell block)

Merkel cell carcinoma metastatic to heart

Neuroblastoma (retropharyngeal mass)

Stomach: carcinoid tumor (left side-fig 4B)

Testis: Leydig cell tumor

Thymic carcinoma (type C thymoma), nonkeratinizing squamous cell carcinoma type

Positive staining - normal

● Adrenal medulla, neuronal cells, neuroendocrine cells, pineal gland

Positive staining - disease

● Neuroendocrine cells / tumors at all sites (carcinoid tumor, neuroendocrine carcinoma, paraganglioma, small cell carcinoma)
● Adrenal gland: adrenocortical adenoma and carcinoma, neuroblastoma, oncocytoma, pheochromocytoma
● CNS: central neurocytoma, gangliocytic paraganglioma, ganglioneuroma and other ganglion cell tumors (Hum Pathol 1990;21:271), medulloblastoma/central PNET, pleomorphic xanthoastrocytoma (variable), retinoblastoma
● Lung: adenocarcinoma-well differentiated fetal type
● Other: desmopslastic small cell tumor, glomus tumor, medullary thyroid carcinoma, Merkel cell carcinoma (Am J Clin Pathol 2011;135:831), myxoid chondrosarcoma (variable), parathyroid carcinoma of thymus (variable)

Negative staining

● Urothelial carcinoma

End of Stains > Synaptophysin

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