Large Cell Neuroendocrine Carcinoma of the Stomach

Abstract

A 69-year-old man was admitted to our hospital with loss of appetite, constipation and diarrhea. Upper gastrointestinal barium study and endoscopy revealed a Borrmann type III-like gastric cancer. Biopsy specimens showed poorly differentiated adenocarcinoma. Total gastrectomy with lymph nodes dissection was performed. The tumor histologically consisted of diffuse proliferation of large and round cells presenting as an organoid, trabecular or sheet-like structure accompanied by a small amount of multinuclear giant cells. The tumor cells were histochemically positive for Grimelius stain and were immunohistochemically, extensively and diffusely positive for chromogranin A. These findings led us to a diagnosis of large cell neuroendocrine carcinoma (LCNEC). This entity of the stomach is not clearly recognized at present. Clinicopathological characteristics of LCNEC of the stomach must be defined so that an appropriate treatment can be developed.