[Heterogeneous carcinoma of the gallbladder with neuroendocrine differentiation]

A heterogenous mostly neuroendocrine small cell carcinoma was found in a gallbladder resected from a 75-year-old man suffering from CLL. It progressed along bile ducts into choledochus, into omentum and liver. Its histology was characterized by solid alveoli and small cell trabeculae with a high mitotic activity, dissociated infiltration in some parts and desmoplasia. Sometimes a typical adenocarcinomatous differentiation could be found out. Tumour cells produced immunohistological expression of EMA, CEA, NSE and CHG and had Grimelius silver impregnation positivity. Neuroendocrine gallbladder carcinomas used to be more aggressive than carcinomas of another type, can cause an endocrine syndrome and claim a special treatment.