title: Large cell neuroendocrine carcinoma of the thymus.
abstract: OBJECTIVE
  We highlight the occurrence of an unusual neuroendocrine tumour, a large cell neuroendocrine carcinoma, arising from the thymus.
  
  
  METHODS
  A 68-year-old man with a history of cigarette smoking had a large mediastinal tumour arising from the thymus removed. Two years later the tumour recurred; it was debulked surgically but the patient died 2 months later: Histological examination of both tumour specimens revealed a tumour with an endocrine pattern, composed of large pleomorphic cells with large nuclei and prominent nucleoli. The mitotic count ranged from 19 to 26 per 10 high-power fields and large tracks of coagulative tumour necrosis were present. The tumour cells were strongly positive for neuron-specific enolase (NSE), chromogranin, CAM5.2 and AE1/3, with cytoplasmic dot-like accentuation for the latter three markers. The tumour fulfilled the criteria for a diagnosis of large cell neuroendocrine carcinoma.
  
  
  CONCLUSIONS
  Large cell neuroendocrine carcinoma should be distinguished from atypical carcinoid and small cell carcinoma. It is a distinctive neuroendocrine malignancy with a prognosis between that of atypical carcinoid and small cell carcinoma, and needs to be treated aggressively.
authors.affiliation: Department of Anatomical Pathology, University of Natal School of Medicine, Durban, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Chetty
authors.forename: S
authors.initials: S
authors.lastname: Batitang
authors.forename: D
authors.initials: D
authors.lastname: Govender
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D018287:Carcinoma, Large Cell / Q000737:chemistry / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry / Q000473:pathology*; D002864:Chromogranins / Q000032:analysis; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D013953:Thymus Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D015415:Biomarkers; D002864:Chromogranins; D010751:Phosphopyruvate Hydratase