Nawarawong N, Pongpruttipan T, Aswakul P, Prachayakul V. Mediastinal small cell carcinoma with liver and bone marrow metastasis, mimicking lymphoma. World J Clin Cases 2015; 3(10): 915-919 [PMID: 26488030 DOI: 10.12998/wjcc.v3.i10.915]
Corresponding Author of This Article
Varayu Prachayakul, Associate Professor, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok 10700, Thailand. kaiyjr@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Napaporn Nawarawong, Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Tawatchai Pongpruttipan, Division of Hematopathology, Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Pitulak Aswakul, Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok 10120, Thailand
Author contributions: Nawarawong N and Pongpruttipan T performed the data collection; Nawarawong N, Aswakul P, and Prachayakul V drafted and reviewed the article; Aswakul P and Prachayakul V revised the article and approved the version to be published.
Institutional review board statement: This article was approved by the Siriraj Internal Review Board.
Informed consent statement: The patient provided written informed consent before this procedure was performed.
Conflict-of-interest statement: The authors have no conflicts of interest related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Varayu Prachayakul, Associate Professor, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok 10700, Thailand. kaiyjr@gmail.com
Telephone: +66-818654646 Fax: +66-24115013
Received: February 8, 2015 Peer-review started: February 10, 2015 First decision: April 24, 2015 Revised: June 12, 2015 Accepted: August 28, 2015 Article in press: September 7, 2015 Published online: October 16, 2015 Processing time: 250 Days and 17.3 Hours
Abstract
Primary mediastinal neuroendocrine tumors are a rare malignancy that accounts for < 10% of all mediastinal tumors. The case presented here involves a 52-year-old man who had been suffering for 3 mo from chronic cough, anorexia and substantial weight loss, as well as 2 wk of jaundice prior to his admission. A computed tomography scan showed a 4.3 cm × 6.6 cm mediastinal mass with multiple liver nodules scattered along both hepatic lobes. Endoscopic ultrasound showed a large heterogeneous hypoechoic mass at the mediastinum with multiple target-like nodules in the liver. Fine-needle aspiration specimens revealed numerous, small, round cells with hyperchromatic nuclei, scarce cytoplasm, and frequent mitotic features. Immunohistochemical study revealed positive results for AE1/AE3, CD56 and chromogranin A, with negative findings for synaptophysin, CK20, vimentin, CK8/18 and CD45. The patient was subsequently diagnosed with a poorly differentiated neuroendocrine carcinoma, small cell type. A bone marrow biopsy also revealed extensive involvement by the carcinoma.
Core tip: Neuroendocrine tumors are rare tumors that arise from the gastrointestinal tract and bronchopulmonary system. Primary mediastinal neuroendocrine tumors are exceptionally rare malignancies, accounting for < 10% of all mediastinal tumors. The common clinical manifestation of this rare tumor is a mediastinal mass, but the condition can mimic lymphoma in advanced cases. The liver is the most common site of metastasis.
