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GENERAL ENDOCRINE TUMORS CATEGORIES WHO classification

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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GENERAL ENDOCRINE TUMORS CATEGORIES WHO classification

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  1. 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

  2. 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

  3. GUT ENDOCRINE TUMORSTUMOR GRADING AND CLASSIFICATIONENETS GRADING PROPOSAL

  4. Size increase ENETS TNM WORKING PROPOSALPANCREAS

  5. Size increase Mets presence ENETS STAGING PROPOSALPANCREAS

  6. 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

  7. 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

  8. 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 +

  9. 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

  10. (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

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