Mixed adenoneuroendocrine carcinoma of the ampulla: Two case reports

Figure 1 Endoscopic retograde cholangiopancreatography showing a cauliflower-like mass at the duodenal papilla (Case 1).

Figure 2 Histological data of Case 1. A: Poorly differentiated adenocarcinoma admixed with neuroendocrine components [hematoxylin and eosin (HE) staining, × 100]; B: The neuroendocrine component was arranged into a nest and the large cells were consistent in size with round nuclei, abundant cytoplasm and coarse chromatin (HE staining, × 100); C: The neuroendocrine carcinoma cells show high mitotic rate (HE staining, × 400); D: Immunohistochemical assay for Ki67 showing high proliferating index (× 100).

Figure 3 Immunohistochemistry for chromogranin A, synaptophysin, CD56 and CK8 of Case 1. A: Immunohistochemistry staining for chromogranin A: the neuroendocrine carcinoma components show strong and diffuse cytoplasmic positivity (× 400); B: Immunohistochemistry staining for synaptophysin: the neuroendocrine carcinoma components show strong and diffuse cytoplasmic positivity (× 400); C: Immunohistochemistry staining showed the neuroendocrine carcinoma cells were positive for CD56; D: Immunohistochemistry staining for CK8: moderate and diffuse cytoplasmic positivity of adenocarcinoma cells (× 400).

Figure 4 Histological data of Case 2. A: Poorly differentiated adenocarcinoma admixed with neuroendocrine components (HE staining, × 100); B: The neuroendocrine components: large cells were characteristic for abundant cytoplasm and nuclear hyperchromatism (HE staining, × 100); C: The neuroendocrine carcinoma cells show high mitotic rate (HE staining, × 400); D: Immunohistochemical assay for Ki67 showing high proliferating index (× 100).