GENERAL ENDOCRINE TUMORS CATEGORIES

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 TUMORS The 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 TUMORS TUMOR GRADING AND
CLASSIFICATIONENETS GRADING PROPOSAL
4
ENETS TNM WORKING PROPOSALPANCREAS
5
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

1. NEUROENDOCRINE CELL HYPERPLASIA AND TUMORLETS
2. TUMORS WITH NEUROENDOCRINE MORPHOLOGY
3. NON-SCLC WITH NEUROENDOCRINE DIFFERENTIATION
4. OTHER TUMORS WITH NEUROENDOCRINE PROPERTIES

Travis et al. WHO Classification of Tumours, 2004
8
THE SPECTRUM OF LUNG NEUROENDOCRINE
PROLIFERATIONS IMMUNOHISTOCHEMISTRY
REQUIRED
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