Pathology Reporting in Neuroendocrine Neoplasms of the Digestive System: Everything You Always Wanted to Know but Were Too Afraid to Ask

Published on Apr 23, 2021in Frontiers in Endocrinology5.555
· DOI :10.3389/FENDO.2021.680305
Manuela Albertelli15
Estimated H-index: 15
(UniGe: University of Genoa),
Federica Grillo24
Estimated H-index: 24
(UniGe: University of Genoa)
+ 4 AuthorsMaria Chiara Zatelli54
Estimated H-index: 54
During the 5th NIKE (Neuroendocrine tumors Innovation in Knowledge and Education) meeting, held in Naples, Italy, in May 2019, discussions centered on the understanding of pathology reports of gastroenetropancreactic neuroendocrine neoplasms. In particular, the main problem concerned the difficulty that clinicians experience in extrapolating relevant information from neuroendocrine tumor pathology reports. During the meeting, participants were asked to identify and rate issues which they have encountered, for which the input of an expert pathologist would have been appreciated. This article is a collection of the most rated questions and relative answers, focusing on three main topics: 1) morphology and classification; 2) Ki67 and grading; 3) immunohistochemistry. Patient management should be based on multidisciplinary decisions, taking into account clinical and pathology-related features with clear comprehension between all health care professionals. Indeed, pathologists require clinical details and laboratory findings when relevant, while clinicians require concise and standardized reports. In keeping with this last statement, the minimum requirements in pathology datasets are provided in this paper and should be a baseline for all neuroendocrine tumor professionals.
#1Marco Volante (UNITO: University of Turin)H-Index: 72
#2Federica GrilloH-Index: 24
Last. Mauro Papotti (UNITO: University of Turin)H-Index: 101
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Neuroendocrine neoplasms of the appendix, colon and rectum are classified according to the most recent WHO classification as neuroendocrine tumors (NET), neuroendocrine carcinomas (NEC) and mixed neuroendocrine-non neuroendocrine neoplasms (MiNENs). NECs and MiNENs are aggressive neoplasms requiring multimodal treatment strategies. By contrast, NETs are, in most cases, indolent lesions occurring as incidental findings in the appendix or as polyps in the rectum. While most appendiceal and rectal ...
#1Andrew M. Bellizzi (UIHC: University of Iowa Hospitals and Clinics)H-Index: 28
Summary This review is based on a presentation given at the Hans Popper Hepatopathology Society companion meeting at the 2019 United States and Canadian Academy of Pathology Annual Meeting. It presents updates on the diagnosis and classification of neuroendocrine neoplasms, with an emphasis on the role of immunohistochemistry. Neuroendocrine neoplasms often present in liver biopsies as metastases of occult origin. Specific topics covered include 1. general features of neuroendocrine neoplasms, 2...
#1Kirstine Nielsen (Copenhagen University Hospital)H-Index: 1
#2Tina Binderup (Copenhagen University Hospital)H-Index: 23
Last. Ulrich Knigge (Copenhagen University Hospital)H-Index: 52
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High grade gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) with a Ki67 proliferation index > 20%, include well-differentiated tumours grade 3 (NET G3) and poorly differentiated (PD) neuroendocrine carcinomas (NEC). Abnormal p53-expression is a feature of PD tumours, while expression of chromogranin A (CgA) and somatostatin-receptor 2a (SSTR-2a) may be a feature of well-differentiated tumours. The aim of this study was to elucidate the expression and prognostic value of these three ma...
#1Iris D. Nagtegaal (IARC: International Agency for Research on Cancer)H-Index: 85
#2Robert D Odze (IARC: International Agency for Research on Cancer)H-Index: 1
Last. Ian A. Cree (IARC: International Agency for Research on Cancer)H-Index: 60
view all 9 authors...
The WHO classification of digestive system tumours presented in the first volume of the WHO classification of tumours series, 5th edition, reflects important advancements in our understanding of tumours of the digestive system (Table ​(Table1).1). For the first time, certain tumour types are defined as much by their molecular phenotype as their histological characteristics; however, in most instances histopathological classification remains the gold standard for diagnosis. The WHO classification...
#1Rita Abi-Raad (Yale University)H-Index: 6
#2John-Paul Lavik (Yale University)H-Index: 1
Last. Guoping Cai (Yale University)H-Index: 14
view all 6 authors...
OBJECTIVES: This study aimed to determine whether Ki-67 index evaluated on cytologic material could reliably grade pancreatic neuroendocrine tumors (PanNETs). METHODS: Cases with adequate cell block and available surgical specimens were included. Ki-67 index was calculated using "eyeballing," "hot spot," and "complete" counting methods. RESULTS: The overall concordance rates between cytology and surgical specimens were 71%, 73%, and 59%, respectively, by using eyeballing, hot spot, and complete ...
Abstract Background Management of neuroendocrine tumors (NETs) depends on the primary site, but the location of many well-differentiated (WD) NETs is elusive. Organ-specific markers are required for pathological diagnosis from biopsy. Transcription factors with good organ specificity include TTF1 (thyroid transcription factor 1; lung), CDX2 (caudal type homeobox transcription factor 2; midgut), and ISL1 (ISL LIM homeobox 1) and PAX8 (paired box 8) for the pancreas and rectum. SATB2 (SATB homeobo...
#1Rebekka MaiH-Index: 1
#2Daniel KaemmererH-Index: 17
Last. Amelie LuppH-Index: 33
view all 8 authors...
Somatostatin receptors (SST), especially SST2A, are known for their overexpression in well-differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). The chemokine receptor CXCR4, in contrast, is considered to be present mainly in highly proliferative and advanced tumors. However, comprehensive data are still lacking on potential differences in SST or CXCR4 expression pattern in GEP-NEN in dependence on the place of origin. Overall, 412 samples from 165 GEP-NEN patients, comprisin...
#1Claudia GrosseH-Index: 7
#2Petar NoackH-Index: 2
Last. Rene SilyeH-Index: 2
view all 3 authors...
OBJECTIVE: The aim of this study was to assess the preoperative tumour grade of pancreatic neuroendocrine neoplasms (panNENs) by determining the Ki-67 index in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) material and to correlate the preoperative tumour grade with the postoperative tumour grade in surgical specimens. METHODS: We performed a retrospective review of the institutional pathology database over a 10-year period (2007-2017) to identify all cases of panNENs with corres...
#1Numbereye Numbere (URMC: University of Rochester Medical Center)H-Index: 1
#2Aaron R Huber (URMC: University of Rochester Medical Center)H-Index: 9
Last. Raul S. Gonzalez (URMC: University of Rochester Medical Center)H-Index: 18
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AIMS: Well-differentiated small intestinal neuroendocrine tumours (SI-NETs) are often multifocal, and this has been suggested to impart worse disease-free survival. Practice guidelines have not been established for World Health Organisation (WHO) grading of multiple primary lesions. METHODS AND RESULTS: We identified 68 patients with ileal/jejunal SI-NET for a combined total of 207 primary lesions. Each case was evaluated for patient age and sex; size of all tumours; presence of lymph node metas...
#1Stefano La Rosa (UNIL: University of Lausanne)H-Index: 41
#2Silvia Uccella (University of Insubria)H-Index: 25
Last. Massimo Bongiovanni (UNIL: University of Lausanne)H-Index: 31
view all 11 authors...
: Mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN) consisting of adenoma and well-differentiated neuroendocrine tumor (NET) has been recently defined as "MANET." However, the clinico-pathologic and pathogenetic features of this entity are not thoroughly studied. We examined the clinico-pathologic features of 12 MANETs by expanding their p53 and β-catenin expression profiles as well as the presence of microsatellite instability and KRAS, BRAF, and PIK3CA mutations in the 2 tumor components...
Cited By1
#1Lorenza Pastorino (UniGe: University of Genoa)H-Index: 26
#2Federica GrilloH-Index: 24
Last. William BrunoH-Index: 21
view all 5 authors...
Genomic studies have identified some of the most relevant genetic players in Neuroendocrine Neoplasm (NEN) tumorigenesis. However, we are still far from being able to draw a model that encompasses their heterogeneity, elucidates the different biological effects consequent to the identified molecular events, or incorporates extensive knowledge of molecular biomarkers and therapeutic targets. Here, we reviewed recent insights in NEN tumorigenesis from selected basic research studies on animal mode...
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