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Exulcerated large cell neuroendocrine carcinoma (80%) with component of moderately differentiated adenocarcinoma (20%) of the colon.
Haematoxylin & Eosin (H&E)
58 years
58-year old male patient with ileus of large intestine with serosal lesion (occult serosal rupture).
Colon wall with solid nests of tumor cells which diffusely infiltrate the tunica muscularis propria and subserosal adipose tissue. The majority of cells show nuclear pleomorphism, prominent nucleoli and abundant cytoplasm (Large cell NEC). Frequent mitoses can be observed. The adenocarcinoma componten was present on a different tissue block.
Immunohistochemical stain for serotonine receptor was negative. Mitotic index: 92 mitoses per 10 high power fields (92/19 HPF).
A high mitotic index is characteristic for neuroendocrine carcinoma as they are by definition G3 tumors (Ki-67 >20%, >20 mitoses per 10 HPF). Although this tumor presents both neuroendocrine carcinoma (80% of total tumor volume) and adenocarcinoma (20% of total tumor volume) it is by definition not a “mixed adeno-neruoendocrine carcinoma (MANEC)” because the classifying criteria which demands that each component exeeds 30% is not fulfilled.
Andrea Bodmer, University of Basel
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