Clinicopathologic features of neuroendocrine carcinomas of the stomach: appraisal of small cell and large cell variants

Arch Pathol Lab Med. 1998 Nov;122(11):1010-7.


Objective: To clarify the clinicopathologic features of neuroendocrine carcinomas (NECs) of the stomach, we reviewed 56 cases of surgically treated gastric carcinomas with a solid growth or with areas containing patterns characteristic for neuroendocrine (NE) tumors.

Methods: Of the 56 cases reviewed, we selected 33 cases of NEC based both on histologic patterns common to NE tumors and on histochemical/immunohistochemical results.

Results: The average age of patients with NEC was 69.8 years (range, 44-92 years). The majority of patients were men (male-female ratio, 23:10). The most frequently affected site was the upper third (46%) of the stomach. Grossly, 9 cases of NEC were fungating and 24 were ulcerated. As compared with 23 patients with non-NEC tumors, the patients with NECs had a worse prognosis. Histologically, NECs had a variety of histologic patterns, including solid, organoid, trabecular, pseudoglandular, spindle cell, and rosettelike. Based on both cell size and morphologic features, we subdivided NECs into 2 variants, namely, small cell NEC and large cell NEC. Our series included 12 cases of small cell NEC and 21 cases of large cell NEC.

Conclusions: Compared with small cell NECs, large cell NECs had a higher mitotic count, larger polygonal cells, a lower nuclear-cytoplasmic ratio, coarser nuclear chromatin, and more frequent conspicuous nucleoli. Large cell NEC was an aggressive tumor with a very poor prognosis (median survival time, 15.2 months; 1-year survival rate, 58%), which approached that for small cell NEC.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Large Cell / metabolism
  • Carcinoma, Large Cell / mortality
  • Carcinoma, Large Cell / pathology*
  • Carcinoma, Neuroendocrine / metabolism
  • Carcinoma, Neuroendocrine / mortality
  • Carcinoma, Neuroendocrine / pathology*
  • Carcinoma, Small Cell / metabolism
  • Carcinoma, Small Cell / mortality
  • Carcinoma, Small Cell / pathology*
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Mitotic Index
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology*
  • Survival Rate


  • Biomarkers, Tumor