Imaging and pathological features of primary hepatic neuroendocrine carcinoma: An analysis of nine cases and review of the literature.

Zhu Chen,Hai-Jiang Huang,Paudel Ramchandra,Hua-En Xiao

doi:10.3892/ol.2014.1844

Abstract

The present study aimed to analyze the imaging features and pathological basis of primary hepatic neuroendocrine carcinoma (PHNEC). A retrospective analysis of the imaging and pathological features of nine PHNEC cases was carried out at The Second Xiangya Hospital of Central South University (Changsha, China). The nine patients were subjected to dynamic contrast-enhanced computed tomography (CT) scanning of the liver and pathological diagnosis of the tissue samples. In addition, two patients were subjected to magnetic resonance imaging (MRI). CT scanning revealed the presence of single or multiple masses in the liver with a maximum diameter of 1–10 cm. These hepatic masses were of low density as showed by plain CT. These masses showed uneven or annular enhancement at their margins in the arterial phase. The venous portal phase showed consistent or declined enhancement and the delayed phase showed light enhancement in these masses. In addition, multiple intrahepatic nodules with long T1 and T2 signal intensities and obvious enhancement were observed by MRI in one patient, while intrahepatic lesions with moderate length T2 signal intensities and light enhancement not visible on the T1 image were observed in another patient. Pathological analysis revealed that the tumor cells exhibited morphological diversity. Immunohistochemical staining revealed that the tumor cells were chromogranin A- and synaptophysin-positive, and carcinoembryonic antigen-, hepatocytic antigen- and α-fetoprotein-negative. Imaging methods, including CT and MRI, are useful for the diagnosis of PHNEC; however, pathological examination is required for a final, definite diagnosis.

Highlights

Neuroendocrine tumors (NETs) are a rare type of tumor, originating from dispersed neuroendocrine cells distributed throughout the body
Due to carcinoid syndrome the symptoms of Primary hepatic neuroendocrine carcinomas (PHNEC) may be varied and different to those for primary hepatocellular carcinoma (HCC) or those of other liver tumors
Nine cases of PHNEC diagnosed by pathological examination following surgery and biopsy between 2007 and 2012 were collected from the Second

Summary

Introduction

Neuroendocrine tumors (NETs) are a rare type of tumor, originating from dispersed neuroendocrine cells distributed throughout the body. Researchers are attempting to diagnose this tumor type early in order to commence treatment sooner. Due to carcinoid syndrome the symptoms of PHNEC may be varied and different to those for primary hepatocellular carcinoma (HCC) or those of other liver tumors. This feature and the rarity of PHNEC make it difficult to diagnose the PHNEC early and accurately prior to performing biopsies or tumor resectioning. Computed tomography (CT) and magnetic resonance imaging (MRI) are emerging as two clinically usefully techniques in oncology These techniques may be used for diagnosis, treatment monitoring and pathophysiologic understanding of PHNEC. To improve knowledge and diagnosis of PHNEC, the present study analyzed the imaging results and pathological features of nine pathologically diagnosed cases

Methods

Results

Conclusion