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Hysterectomy specimen from an 84 year-old female patient.
Large cell neuroendocrine carcinoma is an aggressive tumour with a propensity for rapid recurrence and distant metastases. Patients more often present with high-stage disease, adding to the challenge of management.
This is a very unusual endometrial carcinoma. Sections show diffuse/sheet-like growth of carcinoma cells with high-grade cytology and speckled chromatin. Mitotic figures are numerous (at least 20 per 10 HPFs). Based on the histology differential diagnoses include undifferentiated endometrial carcinoma, dedifferentiated carcinoma, and carcinosarcoma.
The immunoprofile of this entity conists of positive staining for neuroendocrine markers (CD56 and synaptophysin), and is negative for chromogranin. Examining three markers for neuroendocrine differentiation is prudent, since two of the three markers are generally thought to be needed for the diagnosis. In terms of other markers, p16 was positive (patchy) and pankeratin was positive in focal areas.
See related content for references:
Nguyen, ML, et al. Int J Surg Case Rep. 2013; 4(8): 651-655