Primary small cell neuroendocrine carcinoma of the breast

We report and characterize immunohistochemically a case of primary small cell neuroendocrine carcinoma of the breast. The tumor, which arose in the left side, was 18 cm in maximum diameter and microscopically was composed of patternless sheets of undifferentiated small cells with a high nuclear-to-cytoplasmic ratio, hyperchromatic nuclei with indistinct cytoplasm, inconspicuous nucleoli, numerous mitotic figures and large areas of coagulative necrosis. Tumor cells were positive for bcl-2, neuron-specific enolase, synaptophysin, CAM 5.2 and cytokeratin AE1/3, but negative for LCA, CD30, HMB-45, chromogranin A, estrogen receptor, progesterone receptor, Her-2/neu and CD99. The opposite breast harboured an intraductal carcinoma with a focus suggesting microinfiltration, a finding never reported before. In this paper we have also extensively reviewed the literature on the subject, emphasizing the variable immunohistochemical profile and the aggressiveness of mammary small cell carcinoma. The rapidly fatal clinical course of our case, which appears to have the largest dimensions described in literature, underlines the importance of an early diagnosis and treatment for long-term survival.     

Primary neuroendocrine carcinoma of the breast: a case report

Primary neuroendocrine carcinoma of the breast is an extremely rare tumor. We present our experience of primary neuroendocrine carcinoma of the breast in a 76-year-old woman. Surgical biopsies from breast and axillary lymphadenopathy showed a neuroendocrine carcinoma. Immunohistochemical staining of tumor cells with GCDFP15, NSE and chromogranin were positive. Computed tomography scans of the chest and abdomen showed no lesion for metastasis or another primary origin. Adjuvant hormone therapy was given, since the tumor was immunohistochemically receptor positive.     

PRIMARY NEUROENDOCRINE CARCINOMA OF THE SKIN (NERKEL CELL TUMOR)

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Primary neuroendocrine carcinoma of the skin (Merkel cell tumor)]

Primary neuroendocrine carcinoma of the skin (Merkel cell tumor), a rare malignancy originating from the skin, has only been established in the recent years. It has a main predilection on the skin in the head and neck region with an obvious tendency of local recurrence and early metastasis. Histopathologically, it resembles the neuroendocrine carcinoma from other sites of the body in morphology, immunohistochemistry and ultrastructure. Diagnosis of this tumor is quite difficult. Based upon two of our cases as verified by electron microscopy and/or immunohistochemistry, the clinical and pathological features of this tumor are described and the literature reviewed.     

Primary neuroendocrine carcinoma of the mediastinum

A mediastinal mass was found in a 37 year old male who presented with fever, weight loss and fatigue. The chest CT revealed a 9x6x4 cm well circumscribed mass located paratrachaelly in the upper mid-mediastinum. The mass was removed by right thoracotomy. Macroscopically the tumor weighed 195 g and measured 9x6x4 cm. Microscopically the tumor consisted of small blue cells in solid and trabecular pattern. Immunohistochemical studies performed for differential diagnosis of small blue cell tumors. The tumor was diagnosed as primary neuroendocrine carcinoma of the mediastinum. This case is presented for its rare recurrence in that particular location.     

Invasive neuroendocrine carcinoma of the breast

BACKGROUND:

Neuroendocrine carcinoma (NEC) of the breast, a pathologic entity newly defined in the 2003 World Health Organization classification of tumors, is a rare type of tumor that is not well recognized or studied. The purpose of this first case‐controlled study is to reveal the clinicopathologic features, therapeutic response, and outcomes of patients with NEC of the breast.

METHODS:

Seventy‐four patients with NEC of the breast who were treated at The University of Texas M. D. Anderson Cancer Center were analyzed; 68 of them had complete clinical follow‐up. Two cohorts of invasive mammary carcinoma cases were selected to pair with NEC to reveal demographic, pathologic, and clinical features at presentation, along with therapeutic response to treatment and patient outcomes.

RESULTS:

NEC was more likely to be estrogen receptor/progesterone receptor positive and human epidermal growth factor receptor 2 negative. Despite similar age and disease stages at presentation, NEC showed a more aggressive course than invasive ductal carcinoma, with a higher propensity for local and distant recurrence and poorer overall survival. High nuclear grade, large tumor size, and regional lymph node metastasis were significant negative prognostic factors for distant recurrence‐free survival; high nuclear grade and regional lymph node metastasis were also significant negative prognostic factors for overall survival. Although endocrine therapy and radiation therapy showed a trend toward improved survival, the small number of cases in this study limited the statistical power to reveal therapeutic benefits in NEC of the breast.

CONCLUSIONS:

NEC is a distinct type of aggressive mammary carcinoma. Novel therapeutic approaches should be explored for this uniquely different clinical entity. Cancer 2010. © 2010 American Cancer Society.     

PRIMARY NEUROENDOCRINE TUMORS OF THE LIVER AND GALLBLADDER

To study Clinco-pathological characters of the neuroendocrine tumors of the liver and gallbladder.MethodsUsing histology,immunohistochemistry and elec-tron microscope,3 cases of liver and gallbladdcr wereinvestigated.The pimary antibodies including anti-chromogranin A,gastrin,serotonin,insulin,somatostatin,gastrin,pancreatic Polypeptide,adreno-corticotropichormone(ACTH)、calcitonin,bombesin,β-humanchorionic gonadotropin(β-HCG)were employed toidentify the property of tumors.ResultsIn one cases tumor of neuroendocrine carcinonma.In the other two cases tumor were typical carcinoid.Inimmunohistochcmistry study,the tumor cells showedpositive reaction to chromagranin A and containedpositive cells ot gastrin,serotonin,insulin and panereaticpolypaptide.Electronmicroscopy showed the cytoplasmcontained dense round granules.ConclusionThe Nuroendocrine tumor of liver and gallbladderis a spectual type neooplasm with character of histology,immunohistochemistry and electron microscopy.Subjeetheadings neuroendocrine t     

核素显像在神经内分泌肿瘤诊断中的应用

核素显像对于神经内分泌肿瘤的诊断、治疗方案的确定具有重要意义。本文介绍核素显像的分类,SPECT、PET在神经内分泌肿瘤显像中的进展,并对各显像方法进行评价。     

Hepatic ablation for neuroendocrine tumor metastases

The indolent nature of neuroendocrine tumors and their proclivity to be hormonally active warrant aggressive treatment for advanced stage disease with hepatic metastases. Cytoreduction has been associated with improved symptom control as well as prolonged survival compared with those treated with medical therapy. The primary modalities of cytoreduction employed are resection, ablation, and embolization. In particular, radiofrequency ablation has been utilized with good results and minimal morbidity for treating patients with advanced neuroendocrine disease. J. Surg. Oncol. 2009;100:635–638. © 2009 Wiley‐Liss, Inc.     

乳腺小细胞神经内分泌癌(附3例报告)

  目的  探讨乳腺神经内分泌癌的临床病理特征及预后情况。   方法  回顾性分析天津医科大学附属肿瘤医院2003年1月~2010年7月收治的32例乳腺神经内分泌癌的临床特征、病理特点、治疗及预后。   结果  32例乳腺神经内分泌癌均为女性,均以无痛性乳腺肿物就诊,发病年龄36~76岁,（平均58.3岁）。病理检查具有神经内分泌癌的形态学特点,免疫组织化学染色结果突触素（synaptophysin）阳性率为54.5%（6/11）,抗神经特异性烯醇化酶（NSE）阳性率为83.3%（20/24）,嗜铬素A（CgA）阳性率为93.75%（30/32）,ER阳性率为84.375%（27/32）,PR阳性率为68.75%（22/32）,C-erbB-2阳性率为9.375%（3/32）,P53阳性率为18.75%（6/32）。随访时间7~91个月（平均30个月）,除1例患者因全身多发转移死亡,1例患者出现骨转移,1例出现肺部多发转移,均带瘤生存外,余皆无瘤生存。ER与PR之间呈正相关关系（P < 0.01）,且阳性表达率较高;ER、PR均与P53呈负相关关系（P < 0.01、P < 0.05）,P53阳性表达率较低。单纯乳腺神经内分泌癌与伴有其他类型癌的乳腺神经内分泌癌相比,在TNM分期中二者具有明显的差异,且有统计学意义（P < 0.05）。13例伴有其他类型癌的乳腺神经内分泌癌均为高级别的TNM分期,而19例单纯乳腺神经内分泌癌却均为低级别TNM分期。   结论  \t\t乳腺神经内分泌癌是一类少见的特殊类型乳腺癌,病理形态复杂,免疫组织化学染色检测神经内分泌指标是确诊该病的可靠依据。综合治疗有利于提高患者的生存率,延长无病生存时间。本研究提示乳腺神经内分泌癌多为雌孕激素依赖性乳腺癌,可接受内分泌治疗。单纯乳腺神经内分泌癌的TNM分期相对较低,不易发生淋巴结转移,预后较好。仍需大样本长时间随访观察以得出有关乳腺神经内分泌癌的生物学行为及预后的可靠结论。     

微小直肠类癌内镜治疗研究现状

目的 西方国家直肠类癌是第3位的消化道类癌;而在我国,直肠类癌发病居胃肠道类癌的首位.对于直径＜10 mm的直肠类癌而言,是可以选择内镜下治疗的.本文对微小直肠类癌不同内镜下治疗方式的安全性及有效性进行比较.方法 应用CNKI、Medline和PubMed期刊全文数据库检索系统,以“直肠类癌,内镜,治疗”等为关键词,检索2003-1-2015-12的文献,共检索到英文文献184篇,中文文献48篇.纳入标准:(1)内镜下治疗直肠类癌的效果;(2)内镜下治疗直肠类癌的安全性.排除标准:(1)研究目的不是内镜治疗的效果或安全性;(2)其他直肠肿瘤的内镜治疗.根据纳入标准,纳入分析34篇文献.结果 传统的息肉切除术或者内镜下黏膜切除术(endoscopic mucosal resection,EMR)治疗直肠类癌操作简单,但是这两种方法都很难达到完整的组织学切除.透明帽辅助法内镜下黏膜切除术(capassisted EMR,EMR-C)、套扎器法内镜黏膜下切除术(endoscopic submucosal resection with ligating device,ESMR-L)和内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)显示出相似的有效性和安全性.EMR-C和经肛内镜微创手术(transanal endoscopic microsurgery,TEM)能够用作传统息肉切除或EMR没有完整切除后的补救治疗.结论 不同内镜下治疗方式各有利弊,操作者的技术熟练程度在内镜治疗过程中发挥着重要作用,各治疗方式之间的疗效和长期预后的比较还需要大样本研究去评估.     

肺支气管神经内分泌肿瘤的研究现状

支气管肺神经内分泌肿瘤约占所有肺恶性肿瘤的20%,可分为典型类癌、不典型类癌、大细胞神经内分泌癌和小细胞肺癌,其中小细胞肺癌为支气管肺神经内分泌肿瘤最常见的类型。支气管肺神经内分泌肿瘤的诊断主要依靠细胞神经内分泌形态及神经内分泌标志物。现就其临床病理特点、分子特征和研究现状进行综述。     

Primary osteosarcoma of the breast

The typical clinical and diagnostic imaging features of primary osteosarcoma of the breast are presented. © 1993 Wiley-Liss, Inc.     

原发性乳腺非霍奇金淋巴瘤

原发性乳腺非霍奇金淋巴瘤（PNHLB）临床少见,占所有乳腺恶性肿瘤的0．04％～1．10％,占所有非霍奇金淋巴瘤（NHL）的0．39％。好发于中年女性,无特征性临床表现,诊断依赖病理。弥漫性大B细胞淋巴瘤是最常见的病理类型。以化疗为主的综合治疗疗效较好。手术的主要目的在于取得组织标本以明确诊断。预后可能与分期及年龄有关。     

Primary angiosarcomas of the breast

BACKGROUND: The purpose of the study was to describe the clinicopathologic characteristics and clinical outcomes of patients with primary breast angiosarcoma. METHODS: The institutional database was searched to identify breast angiosarcoma patients seen between 1965 and 2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank test was used to compare groups. Cox proportional hazards models were used for multivariate analysis. RESULTS: In all, 69 patients were identified. Median follow-up was 40 months (range, 0-413 months). Median age was 46. Median tumor size at diagnosis was 5.5 cm. Thirteen (18.8%) patients received prior radiation for invasive breast carcinoma. Most patients underwent total mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare. There were 38 recurrences and 27 deaths. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 61% (95% confidence interval [CI], 49%-76%) and 44% (95% CI, 33%-58%) with estimated medians of 100 and 37 months, respectively. In Cox proportional hazards models, OS and RFS were significantly associated only with T size and not with patient age, prior radiation, or chemotherapy administration. Of 29 patients treated with chemotherapy at recurrence, there were 4 complete and 10 partial responses (48%) with an anthracycline-ifosfamide or gemcitabine-taxane combination. CONCLUSIONS: Breast angiosarcoma is frequently advanced at diagnosis and has a tendency for local-regional recurrence. A significant number of responses to chemotherapy was observed in the metastatic setting. These data suggest that a multidisciplinary therapeutic approach should be employed in high-risk patients with large primary tumors.