春节了，小魏在这里也给大家拜年了。恭贺大家龙年心想事成！！
除夕不能和家人团聚，看看文献，时间还过的快点！要不无聊的慌啊。

为了和大家一起拓展思路，以前一直上传文献摘要或者文献和大家分享，
大家的热情不是很高，其实看文献，对于初学者拓宽思路相当有益的，
今天改改老套路，先传文献中的图片，大家猜诊断？然后再传文献。

男，65岁，胃底肿块，顺便猜猜免疫组化是什么？

猜 神经内分泌肿瘤

混合性腺-神经内分泌癌

神经内分泌肿瘤

神经内分泌癌

S-100？

神经内分泌肿瘤

同意！

The Prevalence of Pancreatic Acinar Differentiation in Gastric Adenocarcinoma: Report of a Case and Immunohistochemical Study of 111 Additional Cases (Am J Surg Pathol 2011)
Abstract: Although pancreatic acinar metaplasia in the gastric
mucosa is well recognized in chronic gastritis, gastric carcinoma
with acinar differentiation is very rare. We encountered a case of
gastric adenocarcinoma with prominent histologic and immu-
nohistochemical features of pancreatic acinar differentiation in
the absence of identifiable heterotopic pancreatic tissue. Distinct
glandular and diffuse patterns of adenocarcinoma were also
present, and there was focal mucin production. The tumor
strongly expressed pancreatic exocrine enzymes trypsin and
chymotrypsin, and focal neuroendocrine staining was also
present. To investigate the prevalence of acinar differentiation
in histologically typical gastric cancers, we performed immuno-
histochemical staining for trypsin and chymotrypsin on a tissue
microarray containing 111 conventional gastric adenocarcino-
mas (60 intestinal, 28 mixed, 22 diffuse type, and 1 undiffer-
entiated). No obvious morphologic evidence of acinar
differentiation was identified in any of the 111 cases. Although
some cases showed equivocal staining for at least 1 pancreatic
exocrine enzyme on the initial tissue microarray sections, repeat
immunohistochemical staining on representative whole-tissue
sections failed to reproduce positive staining. Thus, acinar
differentiation is rare in gastric adenocarcinomas, other than in
histologically unusual cases such as the one we report, and in
others from the literature, which are reviewed.

谢谢水若寒！