Preoperative diagnosis of well‐differentiated neuroendocrine tumor in common hepatic duct by brush cytology: A case report

The biological behavior of neuroendocrine tumors (NETs) is heterogeneous and differs from that of cholangiocarcinoma, which is the most common malignant tumor of the biliary tree. However, the preoperative diagnosis of NET in the biliary tree is extremely difficult and to our knowledge, diagnosis by...

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Published inDiagnostic cytopathology Vol. 47; no. 7; pp. 720 - 724
Main Authors Choi, Jiwoon, Lee, Kyong Joo, Kim, Sung Hoon, Cho, Mee‐Yon
Format Journal Article
LanguageEnglish
Published Hoboken, USA John Wiley & Sons, Inc 01.07.2019
Wiley Subscription Services, Inc
Subjects
Bile
Bile ducts
biliary tree
Brushes
Case reports
Cellular biology
Chemotherapy
Cholangiocarcinoma
Cytology
Cytoplasm
Diagnosis
Liver
Mitosis
neuroendocrine tumor
Neuroendocrine tumors
Septum
Staining
Synaptophysin
Tumor cells
Tumors
cytology
neuroendocrine tumor
biliary tree
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Summary:The biological behavior of neuroendocrine tumors (NETs) is heterogeneous and differs from that of cholangiocarcinoma, which is the most common malignant tumor of the biliary tree. However, the preoperative diagnosis of NET in the biliary tree is extremely difficult and to our knowledge, diagnosis by brush cytology has not previously been reported. Herein, we first reported a case of biliary NET preoperatively diagnosed by brush cytology in a 33‐year‐old female patient. Imaging study revealed a 2.6‐cm mass in the common hepatic duct. The brush cytology was characterized by loosely cohesive plasmacytoid tumor cells and scattered clusters of thin vascular septa. The tumor cells showed abundant cytoplasm and severe nuclear size variation but mitosis was not observed. Immunohistochemical staining of the cell block (CB) showed strong positivity for both synaptophysin and chromogranin A and a Ki‐67 labeling index of 3.5%. The surgically resected bile duct mass was pathologically confirmed as NET, G2 with lymphovascular and perineural invasion of the tumor cells. The patient showed no evidence of tumor recurrence 10 months after operation without adjuvant chemotherapy. Suspicion of this rare tumor and immunohistochemical staining of the CB are important for the preoperative diagnosis of NET in the biliary tree.
Bibliography:ObjectType-Case Study-2
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ISSN:8755-1039
1097-0339
DOI:10.1002/dc.24173