Neuroendocrine tumours.pptx

Neuroendocrine tumors
Histopathology based on cases presentations

1. Neuroendocrine tumours; case-based discussion Presented by; Dr. mona rashed Consultant histopathology King khalid hospital- najran

2. introduction Neuroendocrine tumors (also called NETs) represent about 0.5% of all newly diagnosed malignancies. Neuroendocrine tumors are rare, slow-growing tumors that originate in cells of the diffuse neuroendocrine system. They occur most frequently in tissues derived from the embryonic gut.

3. Pathology of net: Neuroendocrine tumors have specific histological and immunohistochemical features based on their anatomical location and endocrine cell type. In the gastric or intestinal wall, they may occur as firm white, yellow, or gray nodules and may be intramural masses or may protrude into the lumen as polypoid nodules.

4. The overlying gastric or intestinal mucosa may be intact or have focal ulceration.

5. Neuroendocrine cells have uniform nuclei and abundant granular or faintly staining (clear) cytoplasm. They are present as solid or small trabecular clusters or are dispersed among other cells, which may make them difficult to recognize in sections stained with hematoxylin and eosin; immunostaining enables their exact identification.

6. Neuroendocrine Neoplasm / Tumor (WHO classification - 2019) 1-Neuroendocrine tumor (NET): NET, grade 1 (G1): well differentiated low grade NET, G2: well differentiated intermediate grade NET, G3: well differentiated high grade 2-Neuroendocrine carcinoma, small cell type (SCNEC) 3-Neuroendocrine carcinoma, large cell type (LCNEC) 4-Mixed neuroendocrine – non-neuroendocrine neoplasm ( MiNEN )

7. N neuroendocrine tumors/ neoplasms Differentiation & grading

8. Case-1 Female ; 36 years old, she has a palpable rectal mass, submucosal “mostly lipoma ” Received at the histopathology department as one polypoid mass measuring 1.2 x 1 x 0.8 cm, with firm consistency and yellowish color on cut section.

9. Ki67 Synaptophysin Chromogranin

10. Final diagnosis

11. Case - 2 Male patient , 62 years old Clinically presented with abdominal pain and conistipation Gastric and duodenal endoscopic biopsy and gastric polyp endoscopic biopsy

12. The gastric polyp show antral gastric mucosa overlying well circumscribed tumor composed of nests of cells surrounded by abundant vascular stroma The case is changing; differential diagnosis included: 1- GIST 2- Gastric carcinoma 3- Neuroendocrine tumor 4- Inflammatory myo- fibrobastic tumour

13. CK/AE1-AE3

14. DOG-1 H-CALDESMONE CD-34

15. CHROMOGRANIN KI-76 SYNAPTOPHYSIN

16. IMMUNOHISTOCHEMISTRY STUDY: NEOPLASM POSITIVE: CHROMOGRANIN SYNAPTOPHYSIN KI 67 <3% NEOPLASM NEGATIVE: CK/AE1-AE3 DOG-1 CD34 H-CALDESMONE

17. Final diagnosis

18. THANK YOU VERY MUCH