Which of the following immunohistochemical marker is positive in neuroendocrine tumor?

Correct Answer: Synaptophysin
Description: Ref. Robbins Pathology. 9th edition. Page. 1099 Though Cytokeratin is also positive in neruroendocrine carcinoma. For neuroendocrine differentiation more specific marker is synaptophysin and chromogranin   WHO classification Typical carcinoids (tcs) Atypical carcinoids (acs) Small cell carcinomas (sccs) Large cell necs (LCNECs)   Carcinoid grade I – ruled out because it lacks comedo-like necrosis, has < 0.2 mitotic figures/HP   Atypical carcinoid: Increased mitotic activity -  per 2-10/10 HPF Pleomorphism and irregular nuclei with hyperchromatism and prominent nucleoli Areas of increased cellularity with loss of the regular, organized architecture observed in typical carcinoid Areas of necrosis within the tumor   Small cell carcinoma – has extensive necrosis (not comedotype as shown in the picture), mitotic figure usually very high (>20/10hpf) and weak staining by neuroendocrine markers   IHC  - Neuroendocrine specific – Synaptophysin, chromogranin, CD56
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