Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study Journal Article
| Authors: | Sigel, C. S.; Werneck Krauss Silva, V.; Reid, M. D.; Chhieng, D.; Basturk, O.; Sigel, K. M.; Daniel, T. D.; Klimstra, D. S.; Tang, L. H. |
| Article Title: | Well differentiated grade 3 pancreatic neuroendocrine tumors compared with related neoplasms: A morphologic study |
| Abstract: | BACKGROUND: Pancreatic neuroendocrine neoplasms with a Ki-67 labeling index greater than 20% were reclassified in 2017 by the World Health Organization into well differentiated (WD) and poorly differentiated grade 3 neuroendocrine carcinoma (NEC). The authors describe the cytologic features of grade 3 WD pancreatic neuroendocrine neoplasms compared with grade 2 neoplasms and NEC. METHODS: Fine-needle aspirates from 65 pancreatic neuroendocrine neoplasms were reviewed, and their cytomorphologic features were compared across grade 2, WD grade 3, and PD small cell type (PD-S), large cell type (PD-L), and type not otherwise specified (PD-NOS) neoplasms. RESULTS: The 65 aspirates consisted of 19 grade 2 neoplasms, 32 WD grade 3 neoplasms, and 14 NECs (6 PD-S, 5 PD-L, and 3 PD-NOS). The medians Ki-67 proliferation index was 11% (range, 3.2%-17%) in grade 2 neoplasms, 40% (range, 21%-89%) in WD grade 3 neoplasms, 80% (range, 63%-95%) in PD-S neoplasms, 39% (range, 25%-61%) in PD-L neoplasms, and 70% (range, 30%-80%) in PD-NOS neoplasms. Both grade 2 and WD grade 3 neoplasms were associated with plasmacytoid morphology and smooth nuclear contours, but WD grade 3 neoplasms had significant increases in abundant cytoplasm (72% vs 17%; P =.007), nuclear tangles (75% vs 42%; P =.006), and apoptosis (86% vs 58%; P =.005). Compared with NECs, WD grade 3 neoplasms had increased plasmacytoid morphology (75% vs 7%; P <.001), smooth nuclear contours (94% vs 64%; P =.02), round nuclei (59% vs 21%; P =.01), and less pleomorphism (13% vs 50%; P =.004), molding (9% vs 79%; P <.001), and necrosis (13% vs 43%; P =.003). WD grade 3 neoplasms had less pleomorphism (13% vs 50%; P =.04), less necrosis (13% vs 60%; P =.04), and more plasmacytoid morphology (75% vs 20%; P =.03) than PD-L. CONCLUSIONS: The prevalence of cytologic features differs in WD grade 3 pancreatic neuroendocrine neoplasms compared with grade 2 neoplasms and NECs, and these differences assist in the recognition of this newly classified entity. Cancer Cytopathol 2018;126:326-35. © 2018 American Cancer Society. © 2018 American Cancer Society |
| Keywords: | pancreas; neuroendocrine differentiation; fine-needle aspiration (fna); pancreas fine-needle aspiration; pancreatic neuroendocrine tumor (pannet); pancreatic neuroendocrine carcinoma; neuroendocrine carcinoma (nec) |
| Journal Title: | Cancer Cytopathology |
| Volume: | 126 |
| Issue: | 5 |
| ISSN: | 1934-662X |
| Publisher: | John Wiley & Sons |
| Date Published: | 2018-05-01 |
| Start Page: | 326 |
| End Page: | 335 |
| Language: | English |
| DOI: | 10.1002/cncy.21982 |
| PROVIDER: | scopus |
| PMCID: | PMC5992011 |
| PUBMED: | 29451738 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 July 2018 -- Source: Scopus |
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