Medullary carcinoma pancreatic

Enolase is a glycolytic enzyme also known as phosphopyru-vate hydratase. Neuron-specific enolase (NSE) is the form of enolase found in neuronal tissue and in the cells of the diffuse neuroendocrine system and the amine precursor uptake, and decarboxylation (APUD) tissue. NSE is found in tumors associated with the neuroendocrine origin, including small cell lung cancer (SCLC), neuroblastoma, pheochromocytoma, carcinoid, medullary carcinoma of the thyroid, melanoma, and pancreatic endocrine tumors. 

CCK receptors SCLC, pancreatic cancers, neuroblastomas, meningiomas, medullary thyroid carcinomas... 

Microsatellite instability (MSI) is a rare event in DAs and such cancers appear to have a distinct morphology called medullary (see later) and improved survival rate relative to those with conventional DAs. " The MLHl gene is often inactivated in MSThigh pancreatic carcinomas (characterized with loss of expression of hMLHl at immunohistochemical level) by either mutation or hypermethylation. 4 2... 

The overwhelming majority of neuroendocrine neoplasms occurring in the liver are metastatic. Well to moderately differentiated neuroendocrine neoplasms (e.g., carcinoids, pancreatic endocrine neoplasms, medullary thyroid carcinomas) may mimic primary hepatocellular processes, and thus immunohistochemistry with antibodies for chromogranin, synaptophysin, and CD56 can be extremely helpful, as discussed earlier. They may also be positive for MOC-31 but not for Hep Par-1. In contrast, HCC may occasionally show focal neuroendocrine differentiation and may stain for synaptophysin. 

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