Abstract
A 75-year-old man was admitted to our hospital because of abdominal fullness. Imaging modalities revealed multiple tumors in the liver, but did not detect other tumors. Endoscopic examination revealed an ulcerated tumor in the duodenum. Biopsies were obtained from the duodenal tumor and liver tumors. The duodenal biopsies revealed malignant cells of composite carcinoid and small cell carcinoma. The carcinoid component showed trabecular and ribbon features, and mitotic figures were seen in one per high power fields, thus fulfilling the criteria of typical carcinoid. By contrast, the small cell carcinoma component showed typical small cell carcinoma features. The liver biopsies showed typical small cell carcinoma. The tumors of both organs were argyrophilic. Immunohistochemically, the tumor cells of both organs were negative for gastrin, somatostatin, serotonin, glucagon, and PP, being compatible with a non-functioning tumor. The duodenal and liver tumors were positive for pancytokeratins, epithelial membrane antigen, chromogranin, synaptophysin, CD56, and neuron-specific enolase. By contrast, they were negative for S100 protein, CD45, CD20, CD3, TTF-1, and calcitonin. Cytokeratin 7 was positive in the carcinoid component but neg...Continue Reading
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