Table 1.
Overview of the morphological and immunohistochemical features of all the tumor samples evaluated.
| Sample | Morphology | Immunohistochemistry | Sample | Morphology | Immunohistochemistry | |
|---|---|---|---|---|---|---|
| Case 1 | surgical | Two neoplastic neuroendocrine components: large-size cells (20% of the whole neoplasm, Ki 67%: 50%), and small-size cells (80% of the whole mass, Ki 67: 90%). Five out of seven nodes showed metastic involvement by the neoplastic neuroendocrine population Revision: Presence of focal epithelial high-grade dysplasia |
Chromogranin A and CD56 positive in both the populations. | Surgical | Cells arranged in glands were described in tunica submucosa, muscularis, and subserosa without involving serosa and mucosa. | Positivity for CK19, CK7, and CDX2; CD56, chromogranin, and synaptophysin all negative. |
| Case 2 | bioptic | Cells characterized by scant eosinophilic cytoplasm, finely granular chromatin, arranged in the lamina propria in an organoid growth pattern. Ki 67 > 55%. Revision: Colorectal high-grade dysplasia along with cells characterized by scant eosinophilic cytoplasm, finely granular chromatin arranged in the lamina propria in an organoid growth pattern. |
Not performed due to the scarcity of tumor sample. | Surgical liver | Poorly differentiated neoplasia (Ki 67: 95%). |
Positivity for CDX2 and CK20; chromogranin and synaptophysin negative. |
| Case 3 | surgical | Two neoplastic components: a colorectal adenocarcinoma G2 occupying 60% of the whole neoplasm and a neuroendocrine carcinoma (40% of the tumor) composed of small cells. Several necrotic areas were present Tumor deposits of neuroendocrine cells were detected. Tunica serosa was infiltrated and ulcerated by both the populations as well as one node out of 11. |
Focal positivity for CK20, synaptophysin, and CDX2. | |||
| Case 4 | surgical | Two populations, each occupying 50% of the whole mass: mucinous adenocarcinoma with signet ring cells and neuroendocrine carcinoma. Tumor cells, diffusely occupied submucosa and muscolaris tunica with just focal mucosal involvement. One out of seven nodes showed neoplastic involvement by both the populations. |
High and diffuse positivity for CK19 and CDX2; low but diffuse positivity for CK20; CK-7 negative. Neuroendocrine markers were just focally positive (dispersed). |