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Clinicopathological features of neoplasms with neuroendocrine differentiation occurring in the liver
  1. Yoriko Nomura1,2,3,
  2. Osamu Nakashima4,
  3. Jun Akiba3,
  4. Sachiko Ogasawara3,
  5. Shogo Fukutomi1,
  6. Rin Yamaguchi3,
  7. Hironori Kusano3,
  8. Masayoshi Kage1,
  9. Koji Okuda2,
  10. Hirohisa Yano3
  1. 1Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka, Japan
  2. 2Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  3. 3Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  4. 4Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Fukuoka, Japan
  1. Correspondence to Professor Hirohisa Yano, Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan; hiroyano{at}


Background/aims We investigated the clinicopathological features of hepatic neuroendocrine tumours (NET) and neuroendocrine carcinoma (NEC), which remain largely unknown.

Material and methods We examined 1235 tumours from 1048 patients who had undergone curative hepatectomy for liver neoplasms at Kurume University Hospital. Pathological diagnoses were based on the 2010 WHO Classification of Tumours of the Digestive System. We performed immunostaining for hepatocyte markers (eg, hepatocyte paraffin (HepPar)-1), neuroendocrine markers (eg, chromogranin A (CGA)) and the proliferation marker (Ki-67).

Results There were four cases of NET G2 (0.38%) and five of hepatic malignant tumours with an NEC component (HNEC) (0.48%). HNEC cases were classified into three types, that is, transitional, intermediate and separate types, according to their histological and immunohistochemical features. In the former two types, the NEC component intermingled with the moderately to poorly differentiated hepatocellular carcinoma (HCC) component or intermediate component consisting of tumour cells showing the colocalisation of CGA and HepPar-1. In the separate type, the NEC and poorly differentiated HCC components were present separately, whereas the sarcomatous HCC component was detected in the vicinity of the NEC component. Ki-67 labelling indices of the NET G2, HCC and NEC components of HNEC were 6.8%, 14.9% and 58.9%, respectively.

Conclusions Primary hepatic NET and NEC are very rare tumours. The NEC component in HNEC showed high proliferative activity and influenced patient prognoses.

  • Neuroendocrine

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  • Handling editor Cheok Soon Lee

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the Journal of Clinical Pathology. Conception of design of the work: YN, ON, RY. Data collection: JA, SO, SF, HK. Data analysis and interpretation: YN, HY. Drafting the article: YN, HY. Critical revision of the article: ON, HY. Final approval of the version to be published: MK, KO, HY.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Kurume University.

  • Provenance and peer review Not commissioned; externally peer reviewed.