Amphicrine Carcinoma of the Duodenum: A Rare Entity
Published: July 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/70486.19590
Supriya Prasad, Renu Sukumaran, Arun Sankar, Madhu Muralee, Priya Appanraj
1. Post Doctoral Certificate Course (PDCC) Oncopathology Fellow, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
2. Associate Professor, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
3. Additional Professor, Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
4. Additional Professor, Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
5. Associate Professor, Department of Imageology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Correspondence
Dr. Renu Sukumaran,
Associate Professor, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram-695011, Kerala, India.
E-mail: renu.sukumaran@gmail.com
Amphicrine carcinoma, in which endocrine and epithelial cell constituents are present within the same cell, is very rare. It is different from adenocarcinoma and Mixed Neuroendocrine-Non neuroendocrine neoplasms (MiNEN). In the current World Health Organisation (WHO) classification of gastrointestinal tumours, the only mention of an amphicrine tumour is in the form of Goblet Cell Adenocarcinoma (GCA) in the appendix, which has both neuroendocrine and non neuroendocrine characteristics in the same cell. Authors hereby report the case of a 63-year-old female who presented with complaints of abdominal pain of a six-month duration. Endoscopy showed a polypoidal lesion in the duodenum. Distal radical gastrectomy was done. Microscopy of the lesion showed atypical signet-ring-like cells and goblet-like mucinous cells with fine granular chromatin. On immunohistochemistry, the tumour cells were positive for CK7, synaptophysin, and chromogranin. The cells showed Periodic Acid-Schiff stain (PAS) positive, diastase-resistant material in the cytoplasm. These cells also showed mucicarmine positivity. Considering the biphenotypic nature of tumour cells, the diagnosis of amphicrine carcinoma was given. Amphicrine carcinomas have unique features in histopathology, immunohistochemistry, special stains, and genetic profile.
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