Poorly Differentiated Neuroendocrine Carcinoma, Ampulla
Vikram Dishpande, MD
Key Facts
Clinical Issues
Aggressive tumors with mean survival of 14.5 months
Microscopic Pathology
Tumors resemble either small cell carcinoma or large cell neuroendocrine carcinoma of lung
Ancillary Tests
Positive for chromogranin and synaptophysin
Reactivity may be focal
For large cell neuroendocrine pattern, immunohistochemical proof of neuroendocrine differentiation is essential
Top Differential Diagnoses
Well-differentiated neuroendocrine carcinoma
High-grade lymphoma
Metastatic pulmonary small cell carcinoma
 This poorly differentiated neuroendocrine carcinoma involves the ampulla  and the duodenum  . |
 The neoplastic cells  of this poorly differentiated neuroendocrine carcinoma show scant cytoplasm, hyperchromatic nuclei, and nuclear moulding. Note the overlying reactive biliary-type epithelium  . |
TERMINOLOGY
Synonyms
High-grade neuroendocrine carcinoma
Small cell carcinoma
Poorly differentiated endocrine carcinoma
Definitions
Clinically aggressive carcinoma of ampulla with neuroendocrine features and high proliferation rate
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