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Endoscopic ultrasound-guided fine-needle aspiration diagnosis of large cell neuroendocrine carcinoma of the gallbladder and common bile duct: report of a case.
[carcinoma of the gallbladder]
Endoscopic
ultrasound-guided
fine-needle
aspiration
(
EUS-FNA
)
allows
a
reliable
and
accurate
diagnosis
of
neoplasms
of
the
gallbladder
and
bile
ducts
.
We
report
the
cytopathologic
findings
of
a
case
of
large
cell
neuroendocrine
carcinoma
(
LCNEC
)
of
the
gallbladder
and
extrahepatic
bile
ducts
in
a
67
-
year
-old
woman
who
presented
with
progressive
abdominal
pain
and
jaundice
.
EUS-FNA
of
the
mass
involving
the
common
bile
duct
and
of
a
porta
hepatis
lymph
node
showed
abundant
cellularity
with
tumor
cells
arranged
singly
and
occasionally
in
tight
and
loose
clusters
and
rosette-like
structures
in
a
background
showing
extensive
necrotic
debris
.
The
tumor
cells
were
predominantly
plasmacytoid
,
showed
a
moderate
amount
of
focally
vacuolated
cytoplasm
and
large
round
to
oval
hyperchromatic
nuclei
with
prominent
nucleoli
,
numerous
mitoses
,
and
apoptotic
bodies
.
The
differential
diagnosis
included
poorly
differentiated
adenocarcinoma
,
lymphoma
,
melanoma
,
and
poorly
differentiated
neuroendocrine
carcinoma
(
NEC
)
,
large
cell
type
.
The
tumor
cells
were
strongly
and
diffusely
positive
for
cytokeratin
AE
1
/
AE
3
,
CD
5
6
,
synaptophysin
,
and
chromogranin
and
showed
a
very
high
proliferative
fraction
on
Ki
67
staining
,
supporting
the
diagnosis
of
a
high
-grade
NEC
.
Due
to
the
large
size
of
the
neoplastic
cells
,
moderate
amounts
of
cytoplasm
and
prominent
nucleoli
,
a
diagnosis
of
LCNEC
was
made
on
the
EUS-FNA
sample
.
Despite
the
prompt
institution
of
chemotherapy
,
the
patient
died
shortly
thereafter
and
the
diagnosis
was
confirmed
at
autopsy
.
This
is
to
our
knowledge
the
first
case
of
LCNEC
of
the
gallbladder
and
bile
ducts
diagnosed
by
EUS-FNA
.
Diseases
Validation
Diseases presenting
"first case"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
canavan disease
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
fabry disease
familial mediterranean fever
focal myositis
gm1 gangliosidosis
harlequin ichthyosis
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
systemic capillary leak syndrome
thoracic outlet syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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