Assessment of cytologic differentiation in high‐grade pancreatic neuroendocrine neoplasms: A multi‐institutional study

Sigel, Carlie S.; Silva, Vitor Werneck Krauss; Reid, Michelle D.; Chhieng, David C.; Basturk, Olca; Sigel, Keith; Daniel, Tanisha; Klimstra, David S.; Tang, Laura H.

doi:10.1002/cncy.21934

Cited by 22 publications

(24 citation statements)

References 10 publications

(26 reference statements)

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“…The cytologic features of WD grade 3 neoplasms have not yet been examined in the context of these related entities. We recently demonstrated that morphologic assessment of grade 3 neuroendocrine neoplasms was challenging for experienced cytopathologists, prompting a comparative analysis of morphologic differences within the grade 3 category …”

Section: Introductionmentioning

confidence: 99%

Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study

Sigel

Silva

Reid

et al. 2018

Cancer Cytopathology

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Section: Introductionmentioning

confidence: 99%

Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study

Sigel

Silva

Reid

et al. 2018

Cancer Cytopathology

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“…Grade 3 panNETs generally resemble grade 1 and 2 tumors and frequently have plasmacytoid morphology and smooth nuclear membranes; however, there is increased abundant cytoplasm, nuclear tangles, and apoptosis; which are features also observed in NEC (Fig. G‐I) . Compared with NECs, grade 3 panNETs have more plasmacytoid morphology, round nuclei, and smooth nuclear membranes and less pleomorphism, angulated nuclei, molding, and necrosis.…”

Section: Differentiation: Cytomorphology and The Use Of Immunohistochmentioning

confidence: 86%

“…Well versus poor differentiation is a crucial component of neuroendocrine neoplasm classification, because it determines therapeutic management. Most neoplasms can be reliably classified by cytomorphology; however, some neoplasms have ambiguous features, particularly grade 3 NETs and large‐cell NECs . In those cases, immunohistochemical stains, clinical history, and genomics can contribute information toward classification .…”

Section: Differentiation: Cytomorphology and The Use Of Immunohistochmentioning

confidence: 99%

Advances in the cytologic diagnosis of gastroenteropancreatic neuroendocrine neoplasms

Sigel

2018

Cancer Cytopathology

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Two‐thirds of neuroendocrine neoplasms arising in the human body originate from the gastrointestinal system or pancreas. Gastroenteropancreatic neuroendocrine neoplasms are heterogeneous, comprising both well differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). The clinical presentation, molecular characteristics, and behavior are distinct for NETs and NECs. Fine‐needle aspiration is an important modality for the primary diagnosis and staging of these neoplasms and can provide information of prognostic and therapeutic significance. Our evolving understanding of neuroendocrine neoplasm biology has led to several iterations of classification. In this review, new concepts and issues most relevant to cytology diagnosis of gastroenteropancreatic neuroendocrine neoplasms are discussed, such as newer detection methods that aid in diagnosis and staging, recent changes in World Health Organization classification, practical issues related to grading these neoplasms on cytology, guidelines for diagnostic reporting, and panels of immunohistochemical stains for the diagnosis of metastasis. The current understanding of genetic and epigenetic events related to tumor development and potential applications for cytology also are presented as they relate to prognostication and recent therapeutic advances.

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“…Neuroendocrine carcinomas are relatively rare tumours as compared to their lower grade, counterparts of NETs . These tumours usually show poorer patient outcomes, shorter disease‐free survival and higher mortality rates . Correct recognition of the disease and grade of the tumours are essential for the optimal therapy and improved patient outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…Extra‐pulmonary NECs have not been studied much in cytology material . In this article, we aim to analyse the cytological features of pulmonary and extra‐pulmonary NECs …”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine carcinomas: Cytological mimics and diagnostic dilemmas

Gupta

Rohilla

et al. 2020

Diagnostic Cytopathology

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Background Neuroendocrine carcinomas (NEC) are rare tumours with multiple morphologic mimics. The cytologist may miss these cases if not aware. Aims and Objects We focused upon the clinical presentation, cytological features and problems in the diagnosis of NEC. Materials and Methods We studied the detailed cytomorphology of 19 cases of NEC (histopathology proved). Results Of these 19 cases of NEC, 15 cases constituted fine needle aspiration (FNA) specimens, one transbronchial needle aspiration specimen, two pleural fluid specimens and a single biliary brushing specimen. All of the FNA specimens were from extra‐pulmonary sites (namely, breast, pancreas, liver and three lymph node FNAs). Eight of the 19 cases (42.1%) showed a significant disparity between cytological and histopathology diagnoses. The break‐up of discordant diagnoses are of adenocarcinoma (three cases), Ewing's sarcoma (one case), infiltrating ductal carcinoma (one case), lymphoma (one case), and squamous cell carcinoma (two cases). The cytology of NECs predominantly showed discrete, round to oval cells with a moderate amount of cytoplasm. The nuclei were pleomorphic, having prominent nucleoli. Occasional cases showed characteristic salt and pepper chromatin and were correctly diagnosed as a neuroendocrine group of tumours. Conclusion The accurate diagnosis of NEC depends on clinical correlation, meticulous screening for any obvious neuroendocrine features and cell block morphology. Immunohistochemistry is essential for ruling out of tumours of neuroendocrine origin. A Ki67 index is mandatory for grading of all neuroendocrine tumours.

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Assessment of cytologic differentiation in high‐grade pancreatic neuroendocrine neoplasms: A multi‐institutional study

Abstract: A purely morphologic approach to the distinction between G2 and G3 pancreatic neuroendocrine neoplasms based on cytology can be challenging, with disagreement found among experienced cytopathologists. Cancer Cytopathol 2018;126:44-53. © 2017 American Cancer Society.

Cited by 22 publications

References 10 publications

Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study

Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study

Advances in the cytologic diagnosis of gastroenteropancreatic neuroendocrine neoplasms

Neuroendocrine carcinomas: Cytological mimics and diagnostic dilemmas

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