Unveiling lipid-rich (“clear cell”) pancreatic neuroendocrine tumor: A small series of two cases with literature review Review


Authors: Xia, R.; Tang, L. H.; Shafizadeh, N.; Xue, Y.; Liu, X.
Review Title: Unveiling lipid-rich (“clear cell”) pancreatic neuroendocrine tumor: A small series of two cases with literature review
Abstract: This study presents two cases of lipid-rich pancreatic neuroendocrine tumors (PanNETs), a rare variant posing significant diagnostic challenges in fine needle aspiration (FNA) cytology and small biopsies. The first case involves an elderly male with a pancreatic tumor, displaying distinct cytoplasmic vacuoles, while the second case is a middle-aged male present with a pancreatic tail mass exhibiting foamy cytoplasm and eccentric nuclei, infiltrating in the stroma. Both cases did not exhibit typical morphologic features of PanNET but demonstrated cytomorphologic features and infiltrative growth patterns that mimicked adenocarcinoma. Further work-up demonstrated that both tumors were immunoreactive for synaptophysin and chromogranin, and were interpreted as well-differentiated, PanNET, lipid-rich variant. The study highlights the overlapping morphological features between lipid-rich PanNETs and other pancreatic neoplasms and underscores the importance of comprehensive cytological and immunohistochemical analysis for accurately diagnosing this variant, particularly due to the risk of misinterpreting it as pancreatic adenocarcinoma. Recognizing lipid-rich PanNETs is crucial for appropriate clinical management, as their identification can significantly impact treatment decisions and patient outcomes. © 2024 Wiley Periodicals LLC.
Keywords: immunohistochemistry; adult; clinical article; aged; middle aged; histopathology; case report; pancreatic neoplasms; cancer staging; nuclear magnetic resonance imaging; cancer grading; diagnostic accuracy; pancreas; cytology; metabolism; computer assisted tomography; lipid; cell differentiation; pathology; immunoreactivity; tumor marker; histology; neuroendocrine tumor; body mass; systematic review; colonoscopy; diagnosis; biopsy, fine-needle; pancreas tumor; lipids; neoadjuvant chemotherapy; genetic screening; perineural invasion; neuroendocrine tumors; pancreas islet cell tumor; synaptophysin; cell vacuole; fine needle aspiration biopsy; clear cell; cancer prognosis; fine needle aspiration; humans; human; male; article; biomarkers, tumor; lipid-rich
Journal Title: Diagnostic Cytopathology
Volume: 52
Issue: 10
ISSN: 8755-1039
Publisher: Wiley Liss  
Date Published: 2024-10-01
Start Page: 582
End Page: 588
Language: English
DOI: 10.1002/dc.25296
PUBMED: 38426360
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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  1. Laura Hong Tang
    447 Tang