Blood Res 2013; 48(2): 75  https://doi.org/10.5045/br.2013.48.2.75
Peritoneal metastasis of a neuroendocrine tumor of the gallbladder
Sang Hyuk Park, and Hyun-Sook Chi

Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.

Published online: June 25, 2013.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

figure

Neuroendocrine tumor (NET) of the gallbladder (GB) (GB-NET) is a very rare condition, representing 0.5% of all NET cases. Here, we report a case of GB-NET with peritoneal metastasis. A 55-year-old man was admitted to our institution for workup for an abdominal distension, which developed 5 weeks ago. Computed tomography (CT) of his abdomen showed ascites and an 18-cm heterogeneous enhancing mass surrounding the GB and invading the liver. Needle biopsy of the GB revealed poorly differentiated sheets of neoplastic cells with hyperchromatic nuclei and indistinct cytoplasm (A, hematoxylin-eosin, ×400). Neoplastic cells were positive for synaptophysin on immunohistochemical staining (B, ×400), but negative for cytokeratin and leukocyte common antigen, indicating neuroendocrine carcinoma, small cell type. Ascitic fluid was centrifuged, and numerous clusters of small to medium-sized neoplastic cells with back-to-back appearance were observed at a frequency of 74% (C, Wright stain, ×400; D, Wright stain, ×1,000). Neoplastic cells were positive for CD56 on immunohistochemical staining (E, ×1,000) but negative for periodic acid-Schiff on cytochemical staining (F, ×1,000). On the basis of these results, the patient was diagnosed as having GB-NET with peritoneal metastasis.



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