The challenge of diagnosing neuroendocrine neoplasms: experience from a national reference center.

IF 3.4 3区 医学 Q1 PATHOLOGY Virchows Archiv Pub Date : 2024-10-29 DOI:10.1007/s00428-024-03957-8
Xixi Zeng, Mengke Ma, Cong Tan, Shujuan Ni, Lei Wang, Meng Zhang, Weiqi Sheng, Shaolei Lu, Dan Huang
{"title":"The challenge of diagnosing neuroendocrine neoplasms: experience from a national reference center.","authors":"Xixi Zeng, Mengke Ma, Cong Tan, Shujuan Ni, Lei Wang, Meng Zhang, Weiqi Sheng, Shaolei Lu, Dan Huang","doi":"10.1007/s00428-024-03957-8","DOIUrl":null,"url":null,"abstract":"<p><p>Correctly diagnosing neuroendocrine neoplasm (NEN) has become increasingly challenging, given that more histomorphologic and immunophenotypic NEN mimics have been identified in recent years. A systemic review was conducted on the 4795 consult cases submitted with initial diagnoses of NEN to a national reference center in China from 2013 to 2021. Among them, 443 cases were misdiagnosed as epithelial NENs after reevaluation with the help of immunohistochemical and/or molecular tests, ranging from 7.1 to 13.2%, with yearly increases. The misdiagnoses varied among age groups and tumor sites. Exocrine carcinoma was the most common (63.2%), followed by mesenchymal tumors. Other common tumors that were misdiagnosed included hepatocellular carcinoma, salivary gland tumor, and gastrointestinal stromal tumor. Aberrant expression of neuroendocrine markers was frequent (218/408, 53.4%), with diffuse positivity ranging from 8.2 to 51.7% for synaptophysin, chromogranin A, and INSM1 stains in all non-NEN cases. Selecting appropriate immunohistochemical stains based on H&E morphology is the key to avoiding diagnostic pitfalls. Medical history and molecular genomic information greatly assist in correctly diagnosing NENs and their mimics.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Virchows Archiv","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00428-024-03957-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Correctly diagnosing neuroendocrine neoplasm (NEN) has become increasingly challenging, given that more histomorphologic and immunophenotypic NEN mimics have been identified in recent years. A systemic review was conducted on the 4795 consult cases submitted with initial diagnoses of NEN to a national reference center in China from 2013 to 2021. Among them, 443 cases were misdiagnosed as epithelial NENs after reevaluation with the help of immunohistochemical and/or molecular tests, ranging from 7.1 to 13.2%, with yearly increases. The misdiagnoses varied among age groups and tumor sites. Exocrine carcinoma was the most common (63.2%), followed by mesenchymal tumors. Other common tumors that were misdiagnosed included hepatocellular carcinoma, salivary gland tumor, and gastrointestinal stromal tumor. Aberrant expression of neuroendocrine markers was frequent (218/408, 53.4%), with diffuse positivity ranging from 8.2 to 51.7% for synaptophysin, chromogranin A, and INSM1 stains in all non-NEN cases. Selecting appropriate immunohistochemical stains based on H&E morphology is the key to avoiding diagnostic pitfalls. Medical history and molecular genomic information greatly assist in correctly diagnosing NENs and their mimics.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
诊断神经内分泌肿瘤的挑战:一个国家参考资料中心的经验。
鉴于近年来发现了更多组织形态学和免疫表型上的神经内分泌肿瘤(NEN)模拟物,正确诊断神经内分泌肿瘤(NEN)变得越来越具有挑战性。我们对2013年至2021年期间提交给中国国家参考中心的4795例初步诊断为NEN的咨询病例进行了系统回顾。其中,443例经免疫组化和/或分子检测重新评估后被误诊为上皮型NEN,误诊率从7.1%到13.2%不等,且呈逐年上升趋势。误诊情况因年龄组和肿瘤部位而异。最常见的是外分泌癌(63.2%),其次是间质瘤。其他常见的误诊肿瘤包括肝细胞癌、唾液腺肿瘤和胃肠道间质瘤。神经内分泌标记物的异常表达很常见(218/408,53.4%),在所有非 NEN 病例中,突触素、嗜铬粒蛋白 A 和 INSM1 染色的弥漫阳性率从 8.2% 到 51.7% 不等。根据 H&E 形态学选择适当的免疫组化染色是避免诊断误区的关键。病史和分子基因组信息对正确诊断 NEN 及其类似物大有帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Virchows Archiv
Virchows Archiv 医学-病理学
CiteScore
7.40
自引率
2.90%
发文量
204
审稿时长
4-8 weeks
期刊介绍: Manuscripts of original studies reinforcing the evidence base of modern diagnostic pathology, using immunocytochemical, molecular and ultrastructural techniques, will be welcomed. In addition, papers on critical evaluation of diagnostic criteria but also broadsheets and guidelines with a solid evidence base will be considered. Consideration will also be given to reports of work in other fields relevant to the understanding of human pathology as well as manuscripts on the application of new methods and techniques in pathology. Submission of purely experimental articles is discouraged but manuscripts on experimental work applicable to diagnostic pathology are welcomed. Biomarker studies are welcomed but need to abide by strict rules (e.g. REMARK) of adequate sample size and relevant marker choice. Single marker studies on limited patient series without validated application will as a rule not be considered. Case reports will only be considered when they provide substantial new information with an impact on understanding disease or diagnostic practice.
期刊最新文献
Heterogeneity of pancreatic neoplasms arising in pancreatic heterotopia: a single institution review. Massive parallel sequencing of head and neck conventional squamous cell carcinomas: A comprehensive review. A molecular and immunohistochemical study of 37 cases of ovarian Sertoli-Leydig cell tumor. Expanding horizons in a new era for pathology: perspectives from the ASCO meeting. Low CXCL11 expression is indicative of poor prognosis in rectal cancer patients undergoing preoperative chemoradiotherapy: a retrospective cohort study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1