Histopathology of gastrointestinal neuroendocrine neoplasms

Hirabayashi, Kenichi; Zamboni, Giuseppe; Nishi, Takayuki; Kajiwara, Hiroshi; Nakamura, Naoya

doi:10.3389/fonc.2013.00002

Cited by 49 publications

(33 citation statements)

References 78 publications

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“…In addition, 28 cases were Syn + CgA -, and 3 cases were CgA + Syn -, which suggested that the expression spectrum of Syn and CgA did not entirely overlap with each other, and any single indicator was not perfect; hence, two or more neuroendocrine markers should be combined to improve the accuracy of GINEN diagnosis. The above-mentioned results were in line with the report of Hirabayashi et al (14).…”

Section: Discussionsupporting

confidence: 83%

Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms

Wang

Chen

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to analyze and summarize the clinicopathological characteristics and factors affecting prognosis for patients with gastrointestinal neuroendocrine neoplasms (GINENs). Retrospective analysis was conducted on the clinicopathological data of 74 patients who were diagnosed with GINEN, and immunohistochemical methods were used to detect the expression levels of relevant markers [synaptophysin (Syn), chromogranin A (CgA) and . Among the 74 cases with GINEN, there were 39 males and 35 females, with an average age of 56.9 years. There were 32 neoplasms in the rectum, 29 in the stomach, 6 in the colon, 2 in the small intestine and 5 in the appendix. All 74 cases underwent surgical resection. According to the World Health Organization Classification of Tumors of the Digestive System (2010), the diagnosis of the 74 cases showed 41 cases (55.4%) of neuroendocrine tumor (NET; 25 cases of G1 and 16 cases of G2), 21 cases (28.4%) of neuroendocrine carcinoma (NEC) and 12 cases (16.2%) of mixed adenoneuroendocrine carcinoma (MANEC). Additionally, 19 cases had metastasis to lymph nodes. During 10-34 months of follow-up, 15 patients had distant metastasis and 24 patients succumbed, and the accumulative survival rate in 1 or 2 years was 87.8 and 74.3%, respectively. Six factors, namely neoplasm size, depth of invasion, lymph node metastasis, distant metastasis, pathological type and the expression or lack of expression of CgA, significantly affected the survival time of patients. Definitive diagnosis of GINEN mainly relies on pathological diagnosis. GINENs with different histopathological types and grading have different clinicopathological characteristics and prognosis: NETs are mainly early lesions with a good prognosis, whereas NECs and MANECs have high malignancy and strong invasion with a worse prognosis.

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Section: Discussionsupporting

confidence: 83%

Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms

Wang

Chen

et al. 2015

Experimental and Therapeutic Medicine

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“…Small-cell carcinoma was the first category described in both the lungs and the GEP tract, and for this reason most of the published literature is focused on small-cell carcinoma. The classic description of small-and large-cell NEC does not perfectly translate to the GEP tract [29,30]. At this time the clinical rel-evance of a distinction between small-cell and large-cell NEC is uncertain, and future clinical and molecular studies are awaited as results may reveal differences that are relevant for treatment and prognosis.…”

Section: Diagnosticsmentioning

confidence: 99%

Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

et al. 2018

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Gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are classified based on morphology and graded based on their proliferation rate as either well-differentiated low-grade (G1 to G2) neuroendocrine tumors (NET) or poorly differentiated high-grade (G3) neuroendocrine carcinomas (NEC). Recently, a new subgroup of well-differentiated high-grade pancreatic tumors (NET G3) has been defined. The GEP NEN G3 group consisting of both NEC and NET G3 has recently been shown to be a quite heterogeneous patient group concerning prognosis and treatment benefit, depending on factors such as the primary tumor site, differentiation, proliferation rate, and molecular alterations. In this review we discuss the existing data on diagnostics, treatment, and biomarkers in this patient group, the unmet needs, and the future perspectives.

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“…Isotopic radiotherapy with the application of somatostatin analogues (DOTA-TOC, DOTA-TATE) labelled 90Y or 177LU can be used when we deal with diffuse G1-2 NETs, with both active and inactive hormonal activity, regardless of the point of origin of the neoplasm, yet, with required expression of the somatostatin receptors confirmed with imaging tests (scintigraphy with the application of somatostatin analogues or (68Ga-DOTA-TATE PET/ /CT) or an immunohistochemical test [12]. The mToR kinase inhibitor (everolimus) and numerous tyrosine kinase inhibitors (sunitinib) provide entirely new possibilities for targeted treatment of the patients with advanced NENs [13]. Control examinations of the patients with advanced NENs include imaging tests (CT, MRI) and determination of the specific markers for this group of neoplasms (cgA and possibly specific markets for particular types of tumours) -for G1-2 NET these tests should be performed every 3-6 months.…”

Section: Mixed Adenoneuroendocrine Tumour (Manet) -Provisional Categorymentioning

confidence: 99%

Mixed adenoneuroendocrine carcinoma: case report and review of literature

Głuszak¹,

Fąfara²,

Kurczab³

et al. 2017

Nowotwory. Journal of Oncology

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Mixed adenoneuroendocrine carcinoma (MANEC) is a rare malignant neoplasm of a complex pathomorphological pattern combining the features of adenocarcinoma with a neuroendocrine component. According to the new classification of the World Health Organization (WHO) from 2010, the nomenclature of neuroendocrine neoplasms (NEN) was changed using this name for the entire group of neoplasms. The name 'neuroendocrine tumours' covers highly diversified neoplasms, determined in the pathomorphological comparison as G1 (NET G1) or G2 (NET G2). In addition, neuroendocrine carcinomas (NEC) and mixed adenoneuroendocrine carcinomas (MANEC) are differentiated. In a search of the the PubMed database, approximately 50 reports about this carcinoma were found, mainly with the location in the stomach, lymph nodes, intestines, liver, peritoneum, gallbladder, pancreas, oesophagus. We have not found a description of the metastatic lesions typical of MANEC in the meninges, brainstem, and lungs. We present the case of a 63-year-old patient who was admitted to the Department of Neurology due to increased dizziness with accompanying diplopia, headache, nausea, and numbness of the hands. These symptoms appeared one day prior to admission, with intensification at night. The patient was initially diagnosed at the Department of Laryngology due to deafness of the right ear and deep hearing loss in the left ear four weeks prior to admission to our department. In the neurological examination, the following findings were detected: conscious, anxious, dysarthric speech, insignificant inspiratory dyspnoea, deafness of the right ear, deep hearing loss in the left ear, pharyngeal and palatal reaction, weak tension of the palato-pharyngeal fold, bilateral signs of central damage of the seventh nerve, insignificant deviation of the tongue to the left, muscle tone of the limbs without deficit, insignificantly decreased muscle tone in the left limbs, ataxia in the lower limbs, bilateral plantar reflex. In the admissions ward, CT examination of the head was performed and a hypodense focus in the left cerebral hemisphere, hypodense foci around the frontal horn of the lateral ventricles and small malacia cavities at the level of the subcortical nuclei were detected. A lumbar puncture was performed obtaining fluid with increased cytosis and a decreased glucose level. On the second day of hospitalisation, the general and neurological condition of the patient significantly worsened and a 'sympathetic storming' appeared followed by circulatory arrest. The patient was efficiently resuscitated, but then there was another sudden cardiac arrest and despite a long period of CPR, cardiac and respiratory action was not restored. After pathomorphological examination it was established that the whole image corresponded to MANEC located in the stomach, with dissemination mainly to the meninges, brainstem and lungs. In differential diagnosis rare causes of diseases must always be taken into consideration. An additional difficulty in diagnosing MANEC is a difference in the na...

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Histopathology of gastrointestinal neuroendocrine neoplasms

Cited by 49 publications

References 78 publications

Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms

Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms

Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

Mixed adenoneuroendocrine carcinoma: case report and review of literature

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