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GENERAL ENDOCRINE TUMORS CATEGORIES WHO classification - PowerPoint PPT Presentation


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GENERAL ENDOCRINE TUMORS CATEGORIES WHO classification. 1. Well differentiated endocrine tumor 2. Well differentiated endocrine carcinoma 3. Poorly differentiated endocrine (small cell) carcinoma 4. Mixed exocrine - endocrine tumor 5. Tumor - like lesion.

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slide1

GENERAL ENDOCRINE TUMORS CATEGORIES

WHO classification

1. Well differentiated endocrine tumor

2. Well differentiated endocrine carcinoma

3. Poorly differentiated endocrine (small cell) carcinoma

4. Mixed exocrine - endocrine tumor

5. Tumor - like lesion

WHO Histological Typing of Endocrine Tumours, 2000/2004

slide2

PURE ENDOCRINE TUMORSThe Differentiation Concept

Well differentiated endocrine neoplasm

1 - tumor (carcinoid)

2 - carcinoma (malignant / atypical carcinoid)

Poorly differentiated endocrine carcinoma

3 - small / intermediate cell carcinoma

slide4

Size increase

ENETS TNM WORKING PROPOSALPANCREAS

slide5

Size increase

Mets presence

ENETS STAGING PROPOSALPANCREAS

slide6

GENERAL NEUROENDOCRINE TUMORS CATEGORIES

lung

Well differentiated neuroendocrine neoplasm

1 - tumor (carcinoid)

2 - carcinoma (malignant / atypical carcinoid)

Poorly differentiated endocrine carcinoma

3 - large cell neuroendocrine carcinoma

4 - small / intermediate cell carcinoma

slide7

THE SPECTRUM OF NEUROENDOCRINE PROLIFERATIONS

lung

  • NEUROENDOCRINE CELL HYPERPLASIA AND TUMORLETS
  • TUMORS WITH NEUROENDOCRINE MORPHOLOGY
  • NON-SCLC WITH NEUROENDOCRINE DIFFERENTIATION
  • OTHER TUMORS WITH NEUROENDOCRINE PROPERTIES

Travis et al. WHO Classification of Tumours, 2004

slide8

THE SPECTRUM OF LUNG NEUROENDOCRINE PROLIFERATIONS

IMMUNOHISTOCHEMISTRY

REQUIRED

TC/AC

CD56 N-CAM +

CgA +

Syn +

Ki67 low

LCNEC

CD56 N-CAM +

CgA +/-

Syn +

Ki67 high

SCLC

CD56 N-CAM +

CgA +/-

Syn +

Ki67 very high

HMWCK -

LMWCK CAM5.2 +

P63/Desmocollin -

TTF1 usually -

HMWCK -

LMWCK CAM5.2 +

P63/Desmocollin -TTF1 usually +/-

HMWCK -

LMWCK CAM5.2 +

P63/Desmocollin -TTF1 usually +

marker expression in endocrine tumors
MARKER EXPRESSION IN ENDOCRINE TUMORS

marker expected positivity

  • LDCV antigens WDET/WDEC/PDEC
  • SSV antigens WDET/WDEC/PDEC
  • cytosol antigens WDET/WDEC/PDEC
  • Ki67 index WDET/WDEC/PDEC
  • P53 WDET/WDEC/PDEC
  • hormones WDET/WDEC/PDEC
  • membrane antigens WDET/WDEC/PDEC
  • FAL/AI/CIN WDET/WDEC/PDEC

(e.g. chromogranin A)

(e.g. synaptophysin)

(e.g. NSE, PGP9.5)

CD56 n-CAM

SST2

neuro endocrine tumors tumor grading and classification summary

(NEURO)ENDOCRINE TUMORSTUMOR GRADING AND CLASSIFICATIONSUMMARY

Differentiation

Tumor definition

Grading

Carcinoid / TC / WDET

Atypical carcinoid / AC / WDEC

SCNEC / PDEC / LCNEC / SCLC

WHO1/G1

Well differentiated

Poorly differentiated

WHO2/G2

WHO3/G3