1. Department of Pathology Tri-Service General Hospital
Reporter: Lin Yi-Jia
Supervisor: Gao, Hong-Wei

2. A 51-Year-Old Woman with abdominal fullness for two weeks

3. Pathological Discussion
Body fluid cytology ( )
Positive for malignancy.
Skin biopsy ( ):
Focal ulceration with confluent corneal necrosis, bacterial colonies and foci of pale upper epidermis. A necrolytic migratory erythema might be considered first.
Foci of pale
upper epidermis of the skin tissue are identified.

4. Pathological Discussion
Liver biopsy ( ):
Focally glandular, solid nested and sheet patterns of tumor cells with moderately nuclear pleomorphism and hyperchromatism, and some mitoses infiltrating in the
stroma.

5. Pathological Discussion
Liver biopsy ( ):
CK18 (+) 400X
CD56 (+) 400X

6. Pathological Discussion
Liver biopsy ( ):
Hepa-1 (-) 400X
Ki X

7. Pathological Discussion
Diagnosis:
Neuroendocrine tumor, grade II
Primary or metastatic？

8. Pathological Discussion
Correlate with clinical information.
Final diagnosis:
Neuroendocrine tumor, grade II with glucagon secretion of pancreas with multiple hepatic metastases and intra-abdominal carcinomatosis with massive ascites

9. Pathological Discussion
Pancreatic NETs and NECs :
Nonfunction
Function
Glucagon
Insulin
Gastrin
Somatostatin
VIPoma

10. Thank for your listening
Reporter: Lin Yi-Jia
Supervisor: Chao, Tai-Kuang