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ArticleVirchows Archiv : an international journal of pathology2026

Gallbladder MiNEN arising in association with an intracholecystic papillary neoplasm exhibiting divergent p53 expression.

Sarra Yacoub, Sana Hidouri, Nihed Abdessayed, Zeineb Nfikha, Wafa Mokni, Mohamed Salah Jarrar, Taghrid Tlili, Badreddine Sriha

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Article in Virchows Archiv : an international journal of pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Sarra YacoubDepartment of Pathology, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia. sarra.yacoub28@gmail.com.ORCID http://orcid.org/0009-0008-1987-6121
Sana HidouriFarhat Hached University Hospital Clinical Research and development Unit of pathology department, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Nihed AbdessayedDepartment of Pathology, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Zeineb NfikhaDepartment of Pathology, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Wafa MokniFarhat Hached University Hospital Clinical Research and development Unit of pathology department, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Mohamed Salah JarrarDepartment of Visceral Surgery, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Taghrid TliliDepartment of Pathology, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.
Badreddine SrihaDepartment of Pathology, Farhat Hached University Hospital of Sousse, Rue Ibn El Jazzar, Sousse, 4000, Tunisia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) of the biliary tract are exceptionally rare and predominantly involve the gallbladder (GB). Their reported association with precursor epithelial lesions raises important questions regarding histogenesis. We report the case of a 74-year-old woman who underwent cholecystectomy for calculus-associated carcinoma. Histological examination revealed a heterogeneous neoplasm composed of three intimately admixed components: an intracholecystic papillary neoplasm (ICPN), a large cell neuroendocrine carcinoma (LCNEC), and a pancreatobiliary-type adenocarcinoma. Both the ICPN and adenocarcinoma components exhibited aberrant p53 immunostaining, whereas the LCNEC showed a wild-type pattern. All components were mismatch repair proficient and demonstrated membranous β-catenin expression. In line with previous reports, this case further suggests that ICPN may represent a common precursor lesion with the potential for divergent differentiation to GB MiNEN. The discordant p53 profiles observed across tumor components may be further explained by clonal evolution and intratumoral heterogeneity.

Indexed as

GallbladderImmunohistochemistryIntra-cholecystic papillary neoplasmMixed neuroendocrine-non-endocrine neoplasmsp53TP53

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.