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Well-differentiated neuroendocrine tumor of the small intestine.
Small Intestine
Haematoxylin & Eosin (H&E)
65 years
65-year old female patient with a tumor of the small intestine 60 cm proximal of the ileocecal valve.
Wall of small intestine with neuroendocrine tumor cells which are organized in a partially trabecular and partially solid pattern. The cells are monotonous and show typical granular chromatin, so called salt and pepper pattern, as well as red cytoplasmic granula. Invasion from the mucosa through the muscularis propria into the subserosal adipose tissue can be appreciated. The tumor has a maximal diameter of 20 mm.
There was a second site of tumor involvement in the small intestine. Immunohistochemically the tumor cells showed 100 % positivity for neuroendocrine markers chromogranin and synaptophysin as well as for the somatostatine receptor. Index of proliferation (Ki-67) was 2% which classifies the tumor as well-differentiated.
Neuroendocrine neoplasms of the small intestine derive from serotonin-producing enterochromaffin (EC) cells. The biology of these tumours is different from other NEN of the digestive tract characterized by a low proliferation rate (vast majority are grade 1 (G1) and grade 2 (G2) and are often indolent; G3 tumours are exceptional.
Andrea Bodmer, University of Basel
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