Adenocarcinoma with neuroendocrine differentiation of the urinary bladder. Clinicopathologic, immunohistochemical, and ultrastructural study.
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Abstract:
We describe a primary mixed adenocarcinoma-neuroendocrine carcinoma of the urinary bladder of probable urachal origin. Neuroendocrine differentiation was confirmed by ultrastructural (neurosecretory granules) and immunohistochemical studies (chromogranin and neuron-specific enolase). Two local recurrences and multiple metastases consisted exclusively of the neuroendocrine component. The patient died 30 months after diagnosis with widely metastatic neuroendocrine carcinoma.Keywords:
Chromogranin A
Neuroendocrine differentiation
Enolase
Synaptophysin
Neuroendocrine carcinoma
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Cytohistological and immunohistochemical features of a rare case of breast carcinoma with diffuse neuroendocrine features occurring in an elderly female patient is reported. Cytology demonstrated predominantly single and loose clusters of monomorphic plasmacytoid tumor cells that possessed moderate amounts of basophilic cytoplasm with eccentrically placed nuclei. These cells were also showing conspicuos rosette like formations. Histological examination showed a typical endocrine pattern with organoid nests and ribbons of well differentiated monomorphic cells with frequent pseudorosette formation resembling carcinoid tumor of gastrointestinal tract. Neuroendocrine differentiation was confirmed by immunohistochemical positivity for neuron specific enolase, synaptophysin and chromagranin.
Synaptophysin
Basophilic
Neuroendocrine differentiation
Enolase
Chromogranin A
Breast carcinoma
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Synaptophysin
Chromogranin A
Neuroendocrine differentiation
Enolase
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Chromogranin A
Carcinosarcoma
Enolase
Neuroendocrine differentiation
Synaptophysin
Sarcomatoid Carcinoma
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To characterize the cytologic spectrum of small cell carcinoma of the urinary bladder, a review of 42 urinary cytology specimens from 13 patients with histologically proven tumors was conducted. Patients ages ranged from 45 to 81 yr (mean 68.9). In four tumors, small cell carcinoma was the sole malignant cellular component: all 11 urinary specimens in these patients harbored cells with features of an undifferentiated small cell carcinoma. In the remaining nine tumors, small cell carcinoma appeared with transitional, squamous cell or adenocarcinoma, but in four, small cell carcinoma was the sole invasive component. Almost one third of urinary specimens in this group lacked a small cell component. Neuroendocrine differentiation was confirmed by immunopathology in eleven cases (neuron specific enolase positive in 11 of 12, synaptophysin in 2/11, chromogranin in 2/13, Leu 7 in 2/7), and by ultrastructural analysis in two. Small cell carcinoma is a cytologically recognizable variant of bladder cancer, but admixture with other malignant components may mask its appearance in urinary specimens.
Chromogranin A
Neuroendocrine differentiation
Synaptophysin
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Small cell carcinoma of the endometrium is extremely rare. The clinical behaviour of this tumour is usually very aggressive. The histopathological distinction of endometrial small cell neuroendocrine carcinoma from mesodermal mixed tumours has important prognostic and therapeutic implications. The case of a 62-year-old white female suffering from postmenopausal bleeding is presented. Macroscopic examination revealed a bulky intraluminal mass with infiltration of more than half of the myometrial wall. In H&E-stained sections atypical small tumour cells revealing neuroendocrine features were found. Immunohistochemical evidence of neuroendocrine differentiation was demonstrated using the markers neuron-specific enolase and synaptophysin. The patient died three months after diagnosis.
Synaptophysin
Neuroendocrine differentiation
Enolase
Chromogranin A
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We describe a primary mixed adenocarcinoma-neuroendocrine carcinoma of the urinary bladder of probable urachal origin. Neuroendocrine differentiation was confirmed by ultrastructural (neurosecretory granules) and immunohistochemical studies (chromogranin and neuron-specific enolase). Two local recurrences and multiple metastases consisted exclusively of the neuroendocrine component. The patient died 30 months after diagnosis with widely metastatic neuroendocrine carcinoma.
Chromogranin A
Neuroendocrine differentiation
Enolase
Synaptophysin
Neuroendocrine carcinoma
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Intraoral localization of neuroendocrine carcinoma, usually called Merkel cell carcinoma, is extremely rare. A case of neuroendocrine carcinoma that was a counterpart of laryngeal neuroendocrine carcinoma but was not a Merkel cell carcinoma, occurring at the mandibular gingiva in a 69‐year‐old Japanese man, is described. The tumor formed a cauliflower‐like mass, measuring 20 × 20 mm, with a small area of necrosis. A computed tomography image showed metastasis in the right submandibular lymph node. Histopathologically, the tumor was composed of immature, small round cells that formed anastomosing trabecular nests. Few mitotic and no necrotic features were observed in the nests. Immunohistochemical studies showed positive staining for chromogranin, synaptophysin and neuron‐specific enolase in the tumor nests. We diagnosed it as an atypical carcinoid (neuroendocrine carcinoma), a counterpart to the same type of tumor occurring in the larynx. The present case is an extremely rare case of neuroendocrine carcinoma without the feature of Merkel cell carcinoma arising from the gingiva.
Synaptophysin
Chromogranin A
Anaplastic carcinoma
Neuroendocrine differentiation
Merkel cell
Enolase
Neuroendocrine carcinoma
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Chromogranin A
Neurofilament
Ependymoma
Neuroendocrine differentiation
Enolase
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Chromogranin A
Enolase
Neuroendocrine differentiation
Neoplasm
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This article describes the first reported case of carcinosarcoma of the urinary bladder with a large cell neuroendocrine epithelial component. A 61 year old man presented with gross haematuria and underwent resection of a biphasic bladder tumour. The malignant epithelial component showed large cell neuroendocrine differentiation with immunohistochemical reactivity for neurone specific enolase, synaptophysin, and chromogranin. The malignant mesenchymal component did not show specific differentiation by histological or immunohistochemical examination. The differential diagnosis of biphasic tumours in the urinary bladder is discussed, along with a review of the literature.
Chromogranin A
Synaptophysin
Carcinosarcoma
Neuroendocrine differentiation
Enolase
Transitional Cell
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Citations (33)