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Metastatic mixed acinar-neuroendocrine carcinoma of the pancreas to the liver: a cytopathology case report with review of the literature. | LitMetric

Metastatic mixed acinar-neuroendocrine carcinoma of the pancreas to the liver: a cytopathology case report with review of the literature.

Diagn Cytopathol

Department of Pathology, Division of Cytopathology, New York University School of Medicine, NYU Langone Medical Center and Bellevue Hospital Center, New York, New York, USA.

Published: February 2013

AI Article Synopsis

  • A case study illustrates a rare instance of metastatic mixed acinar-neuroendocrine carcinoma (MANEC) from the pancreas to the liver, diagnosed through advanced biopsy techniques.
  • The analysis revealed neoplastic cells displaying unique characteristics such as acinar formation and specific nuclear features, supported by strong markers for cytokeratin, chromogranin, and synaptophysin.
  • This report highlights the challenges in diagnosing MANEC and identifies this case as the first to confirm such a diagnosis through cytology combined with histology.

Article Abstract

A case of metastatic mixed acinar-neuroendocrine carcinoma (MANEC) of the pancreas to the liver is reported. A diagnostic percutaneous US-guided FNA and core biopsy of a liver nodule was performed. The FNA smears were cellular and showed neoplastic cells in clusters with acinar formation, isolated single cells, and scattered naked nuclei. The cytoplasm was finely granular. The nuclei were relatively uniform, some with speckled chromatin and prominent nucleoli. The immunohistochemistry performed on the cell block showed strong positivity for cytokeratin AE1/AE3, chromogranin, and synaptophysin. Furthermore, the tumor cells were weakly positive for α1-antichymotrypsin. The Ki-67 mitotic index was up to 50%. Based on the morphology and supporting immunohistochemical stains, the final cytopathologic diagnosis rendered was "Positive for malignant cells. Carcinoma with mixed acinar and endocrine features." To our knowledge, this is the first report of a metastatic MANEC to the liver diagnosed based on cytology with confirmatory histology. The difficulties in the cytopathologic diagnosis and differential diagnosis of MANEC are discussed in this article.

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Source
http://dx.doi.org/10.1002/dc.21799DOI Listing

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