PMC4754118_01
Resected specimen showing two attached ulcerative lesions in the posterior surface of the proximal and middle third of the stomach.
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figure1
On gross examination of the specimen, we identified two attached ulcerative tumours located on the posterior wall of the stomach (Figure 1).
Two separated lesions showing both neuroendocrine carcinoma and tubular adenocarcinoma at H & E.
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figure2
Microscopically, two separated gastric lesions were identified with different patterns in morphology and the distance in between was of 1 mm (Figure 2).
A) Neuroendocrine carcinoma (H & E), B) Moderated tubular adenocarcinoma (H & E), C) Tumour cells with neuroendocrine histology showing cytoplasmic inmunoreactivity for synaptophysin, D) Tumour cells with neuroendocrine morphology showing focal cytoplasmic inmunoreactivity to pankeratin.
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figure3
The cells are distributed in an organoid architecture with solid nests and broad trabeculae solid pattern without glandular formation (Figure 3A). The cells contain variable amounts of eosinophilic cytoplasm with scattered mucin material (Figure 3B). The neuroendocrine phenotype of the large-cell neuroendocrine carcinoma was immunohistochemically confirmed with synaptophysin, which stain all (Figure 3C). Additionally, it showed focal expression for keratin (AE1/AE3) (Figure 3D).