Difference between revisions of "Neuroendocrine neoplasms"

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Neuroendocrine neoplasms (view source)

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'''Neuroendocrine neoplasms''', also '''neuroendocrine tumours''', are a group of tumours whose behaviour varies from benign to malignant and are found in may different sites.  
[[Image:Small intestine neuroendocrine tumour high mag.jpg|thumb|right|200px|Micrograph of a neuroendocrine tumour of the small bowel. [[H&E stain]].]]
'''Neuroendocrine neoplasms''', also '''neuroendocrine tumours''', are a group of tumours whose behaviour varies from benign to malignant and are found in may different sites. ''Neuroendocrine tumour'' is commonly abbreviated '''NET'''.


These tumours arise from epithelium; thus, malignant tumours in this group are referred to as '''neuroendocrine carcinomas'''.
These tumours arise from epithelium; thus, malignant tumours in this group are referred to as '''neuroendocrine carcinomas'''.
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DDx:
DDx:
*[[Paraganglioma]].
*[[Paraganglioma]].
*Neoplasm with neuroendocrine differentiation (<30% neuroendocrine component<ref name=pmid26556999>{{Cite journal  | last1 = Kleist | first1 = B. | last2 = Poetsch | first2 = M. | title = Neuroendocrine differentiation: The mysterious fellow of colorectal cancer. | journal = World J Gastroenterol | volume = 21 | issue = 41 | pages = 11740-7 | month = Nov | year = 2015 | doi = 10.3748/wjg.v21.i41.11740 | PMID = 26556999 }}</ref>).


Images:
==Images==
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Small_intestine_neuroendocrine_tumour_low_mag.jpg Neuroendocrine tumour - low mag. (WC)].
Image:Small_intestine_neuroendocrine_tumour_low_mag.jpg | Neuroendocrine tumour - low mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Small_intestine_neuroendocrine_tumour_intermed_mag.jpg Neuroendocrine tumour - intermed. mag. (WC)].
Image:Small_intestine_neuroendocrine_tumour_intermed_mag.jpg | Neuroendocrine tumour - intermed. mag. (WC/Nephron)
**[http://commons.wikimedia.org/wiki/File:Small_intestine_neuroendocrine_tumour_high_mag.jpg Neuroendocrine tumour - high mag. (WC)].
Image:Small_intestine_neuroendocrine_tumour_high_mag.jpg | Neuroendocrine tumour - high mag. (WC/Nephron)
*www:
</gallery>
**[http://path.upmc.edu/cases/case7/images/micro3.jpg NET met to liver (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case7.html http://path.upmc.edu/cases/case7.html}. Accessed on: 17 December 2011.</ref>
www:
*[http://path.upmc.edu/cases/case7/images/micro3.jpg NET met to liver (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case7.html http://path.upmc.edu/cases/case7.html}. Accessed on: 17 December 2011.</ref>


=IHC - generic=
=IHC - generic=
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Others:
Others:
*NSE +ve.
*NSE +ve.
*CD56 +ve.
*[[CD56]] +ve.
*Ki-67 - useful for grading.
*[[Ki-67]] - useful for grading.
*PGP9.5.<ref name=pmid20182342/>
*PGP9.5.<ref name=pmid20182342/>
*[[CDX2]] -ve/+ve.
**+ve suggests ileum, appendix or colon origin.<ref name=pmid22180832>{{Cite journal  | last1 = Saad | first1 = RS. | last2 = Ghorab | first2 = Z. | last3 = Khalifa | first3 = MA. | last4 = Xu | first4 = M. | title = CDX2 as a marker for intestinal differentiation: Its utility and limitations. | journal = World J Gastrointest Surg | volume = 3 | issue = 11 | pages = 159-66 | month = Nov | year = 2011 | doi = 10.4240/wjgs.v3.i11.159 | PMID = 22180832 }}</ref>
*Serotonin -ve/+ve.
**+ve suggests jejuno-ileal origin.{{fact}}


Hormone products:
Hormone products:
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==Lung==
==Lung==
{{Main|Lung_tumours#Neuroendocrine_tumours}}
{{Main|Lung_tumours#Neuroendocrine_tumours}}
==Genitourinary pathology==
{{Main|Small cell carcinoma of the prostate gland}}
{{Main|Small cell carcinoma of the urinary bladder}}


==Gastrointestinal tract==
==Gastrointestinal tract==
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===Stomach===
===Stomach===
Divided into four types:<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/StomachNET_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/StomachNET_11protocol.pdf]. Accessed on: 29 March 2012.</ref>
{{Main|Gastric neuroendocrine tumour}}
{| class="wikitable sortable"
!Tumour type
!Relative prevalence
!Multifocality
!Tumour size
!Typical location
!Clinical
!Other
!Histology
|-
|Type 1
| ~75%
| yes
| small (5-10 mm)
| body
| benign typically, female:male ~ 4:1, 50-60 years
| chronic atrophic gastritis - usu. autoimmune
| WDNET, WDNEC
|-
|Type 2
| rare
| yes
| small ~15 mm
| body
| aggressive, ~50 years old
| assoc. [[MEN I]], hyperchlorhydia
| WDNEC, WDNET
|-
|Type 3
| 10-15%
| no
| small and large
| variable location
| aggressive if >2.0 cm, males > females
| normal gastrin levels
| WDNET
|-
|Type 4
| extremely rare
| no
| large
| variable location
| aggressive (mets usu. at time of Dx), males > females
| elevated gastrin d/t parietal cell dysfunction
| PDNEC
|-
|}
Notes:
*WDNET = well-differentiated neuroendocrine tumour.
*WDNEC = well-differentiated neuroendocrine carcinoma.
*PDNEC = poorly-differentiated neuroendocrine carinoma.


===Duodenum===
===Duodenum===
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*[[Basics]].
*[[Basics]].
*[[Goblet cell carcinoid]].
*[[Goblet cell carcinoid]].
*[[Mixed neuroendocrine-nonneuroendocrine neoplasm]] (MiNEN).


=References=
=References=
Michael
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