A case of small cell neuroendocrine carcinoma of gallbladder

Abstract

Background : Small cell neuroendocrine carcinoma (small cell NEC) of the gallbladder is very rare. We report a case of small cell NEC diagnosed by bile cytology, with a review of the literature.

Case : The patient was a female in her 80’s, suspected as having obstructive jaundice caused by malignant biliary stricture. Endoscopic retrograde cholangiopancreatography (ERCP) was performed. Cytology revealed small atypical cells with a very high N/C ratio occurring in small clusters, in the so-called “Indian-file pattern”. The cytological findings were similar to those of small cell carcinoma of other organs, and the patient was diagnosed as having small cell NEC. She died on the seventh day of hospitalization, and autopsy examination was performed. The findings confirmed small cell NEC of the gallbladder.

Conclusion : Adenocarcinoma is the most common malignant neoplasm diagnosed by bile cytology. It is important that careful screening be performed to rule out coexistence of adenocarcinoma with other histological types. In bile cytology, cell degeneration can occur easily, therefore careful handling of the specimens is required. Small cell NEC of the gallbladder is highly malignant and carries a poor prognosis ; therefore, early diagnosis and early treatment are critical. Bile cytology is a useful tool for making an early diagnosis of small cell NEC of the gallbladder.