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Renato Cannizzaro,1 Stefania Maiero,1 Mara Fornasarig,1 Vincenzo Canzonieri,2 Raffaella Magris,1 Giovanni Guarnieri,1 Martina Urbani,3 Angela Buonadonna,4 Tanja Baresic,5 Paola Spessotto61Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; 2Pathology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; 3Oncologic Radiation Therapy and Diagnostic Imaging, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; 4Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; 5Nuclear Medicine, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; 6Molecular Oncology, Department of Translational Research, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, ItalyAbstract: The potential role of the probe-based confocal laser endomicroscopy (pCLE) has been analyzed in different pathologic conditions of the gastrointestinal tract. Here, we analyzed a case of extrapulmonary high grade neuroendocrine rectal carcinoma (HGNEC) using, for the first time, the pCLE system. A 72-year old man was diagnosed with an 8 cm diameter rectal HGNEC by standard colonoscopy integrated with the pCLE system. The diagnosis of neuroendocrine carcinoma was confirmed by immunohistochemical analyses. By using the pCLE system, we well defined and resolved vascular structures and mucosal architecture. An altered mucosal pattern and vascular defects, peculiar for HGNEC, were observed at high magnification, allowing the identification of a pattern which was quite different from that observed in poorly differentiated adenocarcinomas (PDA) where tissues appear darker, very irregular, even if glandular structures can still be recognized. This underlines the usefulness of pCLE in discriminating HGNECs from PDAs. In conclusion, pCLE could represent a valid and helpful method for in vivo HGNEC diagnosis, allowing prompt and careful management of the patient.Keywords: probe-based confocal endomicroscopy, neoangiogenesis, extrapulmonary high grade neuroendocrine carcinoma, poorly differentiated adenocarcinoma |
