Qap (Anatomical Pathology) 

QAP Peer Review

AP282
Case History: M/73 Anal polyp with transanal resection done.
Intended diagnosis: Small cell carcinoma and villous adenoma. Contributed by:USK
Code Diagnosis Comment Score
anonymous Malignant small round cell tumour. (100%). Differential diagnoses include small cell carcinoma, Merkel cell carcinoma and hematolymphoid malignancy. Immunostains for CK, CK20, synaptophysin, B & T-cell markers, TdT.  100
anonymous small cell carcinoma nil  100
anonymous Neuroendocrine carcinoma (grade 3, W.H.O.) 90%. Poorly differentiated carcinoma, high grade. 10% To be confirmed by immunohistochemical stains for synaptophysin, chromogranin, CD56, cytokeratin.  100
anonymous Small cell carcinoma nil  100
anonymous Small cell carcinoma. Confirm by chromogranin+, synaptophysin+, CK+ (perinuclear dots), LCA-.  100
anonymous Small cell neuroendocrine carcinoma.(100%) nil  100
anonymous Anal polyp - Carcinoma 100% (favor small cell CA/neuroendocrine carcinoma) Immunostains with keratin and neuroendocrine markers for confirmation  100
anonymous Neuroendocrine carcinoma 90%, malignant melanoma 10% Immunostaining for neuroendocrine markers (synaptophysin, chromogranin) positive for neuroendocrine carcinoma), S-100 protein and HMB45 (positive for malignant melanoma).  100
anonymous Poorly differentiated neuroendocrine carcinoma. 100%. Differential diagnoses include other poorly differentiated carcinoma and high grade lymphoma. Immunohistochemical studies, including epithelial markers (like Cam 5.2), chromogranin, synaptophysin, NSE, etc, are advised to confirm the diagnosis. LCA may help to exclude a high grade lymphoma.  100
anonymous Neuroendocrine carcinoma, small cell type. nil  100
anonymous ANUS - SMALL CELL (NEUROENDOCRINE) CARCINOMA nil  100
anonymous Malignant tumor, in favor of neuroendocrine carcinoma. (Please see comment for differential diagnosis) Differential diagnosis includes hematolymphoid malignancy, small cell variant of malignant melanoma and Ewing sarcoma/PNET. A panel of immunohistochemical stains is needed for definitive diagnosis. They include AE11/3, synaptophysin, chromogranin, leucocyte common antigen, MPO, HMB45, S-100, CD99 and FLi1 stain.  100
anonymous Poorly differentiated neuroendocrine carcinoma (small cell type) nil  100
anonymous small cell carcinoma (100%) nil  100
anonymous Small round cell tumour , favour poorly differentiated carcinoma, need to rule out neuroendocrine carcinoma, perform chromogranin, synaptophysin, CD56 (100% Probability) nil  100
anonymous Malignant small round cell tumour, favour small cell carcinoma (80%). Differential diagnoses include Merkel cell carcinoma (10%) and malignant melanoma (10%). Immunostaining for cytokeratin, neuroendocrine markers (synaptophysin, chromogranin), CK20 and S-100 protein to help establish the diagnosis.  100