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..so I guess it was positive for chromogranin, synaptophysina and p56. However I do see small prominent nucleoli and small cell carcinomas do not have such..only SNUC sinonasal undiff carcinoma as well as oflactory neuroblastoma have nucloli. the ONB has very small nucleoli. This is a good review article I happen to see a while ago:http://www.nature.com/modpathol/journal/v15/n3/full/3880522a.html

----Comment by: savco on 3/7/2008 2:26:49 PM

Great article. Definitely one of the concept papers I was referring to above. Poorly/undiff NEC (small cell NEC), SCNC, will have variable IHC staining patterns, and caution should be used in relying on these for this tumor phenotype. Interesting point about the nucleoli. While SCNC should not have prominent nucleoli, the chromatin pattern was very suggestive. Also the growth pattern was trabecular, and ribbon like, also suggestive of NEC. BUT, SNUC can have a similar growth pattern as well. Which gets to the point of controversy in classifying these tumors. Mills in the paper you referred to above suggests that SNUC fall under the large cell neuroendocrine tumor category. I do not know what the synapto/chrom profile of this tumor was, nor do I know if S100 was used (peripheral S-100 protein–positive cells seen in olfactory neuroblastomas). Calling this SNUC vs small cell neuroendocrine carcinoma is not as important as NOT calling this ONB (which has a much better prognosis than the other two). Challenging case.

----Comment by: Iago on 3/8/2008 11:29:32 AM

     

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