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CASE REPORT
Year : 2020  |  Volume : 6  |  Issue : 2  |  Page : 152-154

Neuroendocrine neoplasm of liver with intratumoral discordance of mitotic and Ki-67 proliferation index


Department of Pathology, Pondicherry Institute of Medical Sciences, Puducherry, India

Correspondence Address:
Bakiarathana Anand
20, 1st Floor, Thirumurugan Street, Kamaraj Nagar, Puducherry - 605 011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_15_20

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A 70-year-old female presented with backache and was found to have multiple lesions in the liver along with additional lesions in the sacral bone, adrenal, and the tail of pancreas. Six computed tomography-guided core biopsies from single lesion in the liver showed a neoplasm composed of small cells with fairly uniform, round nuclei and granular eosinophilic cytoplasm arranged around dilated vascular channels. Mitotic index was 3/10 high-power fields. A suspicion of neuroendocrine neoplasm (NEN) was confirmed by positive immunohistochemistry for synaptophysin. The Ki-67 proliferation index was 30%–40%. These findings confirmed metastatic NEN in the liver with intratumoral discordance in mitotic index of Grade 2 and Ki-67 proliferation index of Grade 3 according to the WHO 2017 grading of gastroenteropancreatic NEN. The discordance between primary and secondary NEN is known; however, the discordance of mitotic and Ki-67 index within the same tumor is unusual and hence we report this case.


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