A Case of Metastatic Hepatic Neuroendocrine Tumor from the Lung Diagnosed by Thyroid Transcription Factor (TTF) -1 Immunostaining

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  • TTF-1染色により診断した肺原発神経内分泌腫瘍肝転移の1例
  • TTF-1 センショク ニ ヨリ シンダン シタ ハイ ゲンパツ シンケイ ナイブンピ シュヨウ カン テンイ ノ 1レイ

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Abstract

<p>A 66-year-old woman was referred to our hospital because a hepatic mass was newly detected through abdominal US executed routinely every year. Abdominal CT showed a 40-mm low density area with slight contrast effects in the segment 6 of the liver. Tumor markers were within normal ranges. CT also showed a solitary nodule of 8 mm in diameter in the segment 8 of the right lung, which was to be observed because of its size and unknown origin. On the other hand, the liver tumor was to be resected because of its rapid growth implicating a malignant potential. Histologically, the liver tumor was composed of proliferation of spindle-shaped atypical cells with a high NC ratio. Immunostaining revealed that the tumor cells were both chromogranin-A and synaptophysin positive, which indicated the tumor to be neuroendocrine origin. Thyroid transcription factor (TTF)-1 was also positive which suggested the tumor could be originated in the lung. The lung tumor was then excised by a thoracoscopy-assisted right S8 resection. Pathological findings were consistent with those of the liver, which confirmed that the lung was the primary site and the liver was the metastatic site. TTF-1 staining was useful to determine the primary site of neuroendocrine tumor developed in the liver.</p>

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