Composite papillary intestinal-type adenocarcinoma/poorly differentiated neuroendocrine carcinoma of the ampulla of Vater

Vilardell, Felip; Velasco, Ana; Cuevas, Dolors; Olsina, Jorge Juan; Matías‐Guiu, Xavier

doi:10.1136/jcp.2010.084954

Cited by 10 publications

(10 citation statements)

References 10 publications

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“…These constitute a morphologically distinct population (30%) of mucinproducing adenocarcinoma or rarely squamous cell carcinoma, intimately admixed intermixed or adjacent to a neuroendocrine component. The neuroendocrine component is generally low grade and is rarely high grade (11). MANECs should be considered as carcinomas.…”

Section: Similar To Our Study Maggard Et Al and Modlin Et Almentioning

confidence: 99%

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Uppin¹,

Uppin²,

Sunil³

et al. 2017

J. Gastrointest. Oncol.

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Background: The gastroenteropancreatic neuroendocrine tumors (GEPNET) have a characteristic histologic appearance unrelated of the exact site of origin. However the behavior of these tumors are different in each of these sites. In this article we study the clinicopathological features of GEPNET. These tumors were classified and graded according to WHO 2010 criteria. The immunohistochemical (IHC) features were evaluated and the grade of the tumor was correlated with Ki67.Methods: A total of 40 cases of GEPNET diagnosed on biopsies as well as resected specimens were analyzed from January 2012 to June 2015.Results: There were 28 resected specimens and 12 biopsies. Majority of the gastric neuroendocrine tumors (NET) showed classic morphology of cells arranged in islands. There were 3 cases each of grade 1 and grade 2 and one was diagnosed as mixed adenoneuroendocrine carcinoma (MANEC). All the duodenal NET were well differentiated (grade 1). There were 8 cases in colon and rectum, of which 4 cases were grade 3 and 3 cases were grade 2. Majority of the pancreatic tumors were grade 1. The mean mitotic count along with ki67 had good correlation in NET of stomach, duodenum colon and rectum. Conclusions:The most common site was small intestine followed by pancreas. Majority of the tumors were NET G1. Tumors from colorectal region were mostly NEC G3. There was a strong correlation by spearman correlation analysis between Ki67 and mitotic count and moderate correlation between ki67 and tumor grade as well as mitotic rate and tumor grade. Ki67 was helpful in grading these tumors.

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Section: Similar To Our Study Maggard Et Al and Modlin Et Almentioning

confidence: 99%

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Uppin¹,

Uppin²,

Sunil³

et al. 2017

J. Gastrointest. Oncol.

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“…In this report, we described the second reported cytological case of MANEC with adenoma component of the ampulla of Vater, and analyzed the immunocytochemical characteristics of this type of tumor for the first time. To the best of our knowledge, only 16 cases of MANEC of the ampulla of Vater have been reported in the English language literature . Table summarizes the clinicopathological features of the previously reported cases as well as the present one.…”

Section: Discussionmentioning

confidence: 85%

“…Preoperative diagnosis of MANEC of the ampulla of Vater is difficult, because only adenocarcinoma component was detected in the preoperative examination in the majority of cases . Of note, only one case of the previously reported cases achieved preoperative diagnosis of MANEC, in which the cytological examination successfully detected both small cell carcinoma and signet ring cell carcinoma components .…”

Section: Discussionmentioning

confidence: 90%

“…Mixed adenoneuroendocrine carcinoma (MANEC) is defined as a tumor that has morphologically recognizable both adenocarcinoma and neuroendocrine carcinoma (NEC) components comprising at least 30% of either component by the recent WHO Classification . The occurrence of MANEC in the ampulla of Vater is extremely rare; only 16 cases have been reported in the English language literature . Moreover, only two cases of cytological features of this type of rare tumor have been documented in one report …”

Section: Introductionmentioning

confidence: 99%

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Cytological features of mixed adenoneuroendocrine carcinoma of the ampulla of Vater: A case report with immunocytochemical analyses

Yoshioka

Ebisu

Ishida

et al. 2018

Diagnostic Cytopathology

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Mixed adenoneuroendocrine carcinoma (MANEC) is defined as a tumor that has morphologically recognizable both adenocarcinoma and neuroendocrine carcinoma components comprising at least 30% of either components. MANEC occurring in the ampulla of Vater is extremely rare, and only 16 cases have been reported in the English language literature. In the present report, we describe the first case of MANEC of the ampulla of Vater with immunocytochemical analyses. An 82-year-old Japanese male was incidentally found to have a tumorous lesion in the ampulla of Vater. Endoscopic ultrasound-fine needle aspiration (EUS-FNA) of the tumor was performed. The Papanicolaou smear demonstrated the presence of different three components. The most dominant component was cohesive clusters of small round cells with round to oval nuclei with powdery chromatin and scant cytoplasm, which corresponded to small cell carcinoma. The second component was an adenocarcinoma, which was composed of irregularly overlapping clusters of tall columnar cells with large round to oval nuclei containing conspicuous nucleoli. The third component was an adenoma, which was comprised of flat cohesive clusters of columnar cells without atypia. Immunocytochemical analyses demonstrated that synaptophysin was expressed in the small round cells, and cdx-2 was expressed in all three components. Accordingly, a cytodiagnosis of MANEC with adenoma component was made. Preoperative diagnosis of ampullary MANEC is difficult. However, this report clearly demonstrates three different components in the EUS-FNA cytological specimen. Therefore, we suggest that cytological examination is a useful method for diagnosis of MANEC of the ampulla of Vater.

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“…In most cases the neuroendocrine component is low grade, but may occasionally be high grade. 32 Generally, MANECs behave as adenocarcinomas and should be staged as such.…”

Section: Proximal Duodenum and Ampulla Netsmentioning

confidence: 99%

Neuroendocrine Tumors of the Luminal Gastrointestinal Tract

Grin

Streutker²

2015

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Neuroendocrine tumors (NETs) of the gastrointestinal tract have been recognized for more than a century. Despite histologic similarities between different sites in the tract, behavior varies between areas. All of these tumors have malignant potential, but determination of exact risk is difficult.Objectives.-To review the diagnosis of luminal gastrointestinal NETs, including a discussion of grading. Grading by mitotic index/activity, in conjunction with tumor size/ stage, has been found to be the strongest predictor of behavior.Data Sources.-Literature review of luminal gastrointestinal NETs was performed and the results summarized.Conclusions.-Our understanding of these lesions is incomplete and continues to evolve.

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Composite papillary intestinal-type adenocarcinoma/poorly differentiated neuroendocrine carcinoma of the ampulla of Vater

Cited by 10 publications

References 10 publications

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Clinicopathologic study of neuroendocrine tumors of gastroenteropancreatic tract: a single institutional experience

Cytological features of mixed adenoneuroendocrine carcinoma of the ampulla of Vater: A case report with immunocytochemical analyses

Neuroendocrine Tumors of the Luminal Gastrointestinal Tract

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