Journal article
Immunohistochemistry in the diagnosis and classification of neuroendocrine neoplasms: what can brown do for you?
Human pathology, Vol.96, pp.8-33
02/2020
DOI: 10.1016/j.humpath.2019.12.002
PMCID: PMC7177196
PMID: 31857137
Abstract
This review is based on a presentation given at the Hans Popper Hepatopathology Society companion meeting at the 2019 United States and Canadian Academy of Pathology Annual Meeting. It presents updates on the diagnosis and classification of neuroendocrine neoplasms, with an emphasis on the role of immunohistochemistry. Neuroendocrine neoplasms often present in liver biopsies as metastases of occult origin. Specific topics covered include 1. general features of neuroendocrine neoplasms, 2. general neuroendocrine marker immunohistochemistry, with discussion of the emerging marker INSM1, 3. non-small cell carcinoma with (occult) neuroendocrine differentiation, 4. the WHO Classification of neuroendocrine neoplasms, with discussion of the 2019 classification of gastroenteropancreatic neoplasms, 5. use of Ki-67 immunohistochemistry, 6. immunohistochemistry to assign site of origin in neuroendocrine metastasis of occult origin, 7. immunohistochemistry to distinguish well-differentiated neuroendocrine tumor G3 from poorly differentiated neuroendocrine carcinoma, 8. lesions frequently misdiagnosed as well-differentiated neuroendocrine tumor, and 9. required and recommended data elements for biopsies and resections with associated immunohistochemical stains. Next-generation immunohistochemistry, including lineage-restricted transcription factors (e.g., CDX2, islet 1, OTP, SATB2) and protein correlates of molecular genetic events (e.g., p53, Rb), is indispensable for the accurate diagnosis and classification of these neoplasms.
•The WHO 2019 classification of gastroenteropancreatic neuroendocrine neoplasms closes the G1/2 Ki-67 “hole,” establishes the category neuroendocrine tumor (NET) G3, and introduces the term “mixed neuroendocrine-non-neuroendocrine neoplasm”•INSM1 has emerged as a general neuroendocrine marker on par with chromogranin A and synaptophysin, with the advantage of increased sensitivity in poorly differentiated neuroendocrine carcinoma (NEC)•CDX2 (midgut), islet 1 (pancreas), OTP (lung), and SATB2 (rectum) are the “best” markers to assign NET site of origin•p53 and Rb are the “best” markers to distinguish NET G3 from NEC•TTF-1 (lung and extrapulmonary viscera) and CK20 (skin) are (still) the “best” markers to assign NEC site of origin
Details
- Title: Subtitle
- Immunohistochemistry in the diagnosis and classification of neuroendocrine neoplasms: what can brown do for you?
- Creators
- Andrew M Bellizzi - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Human pathology, Vol.96, pp.8-33
- DOI
- 10.1016/j.humpath.2019.12.002
- PMID
- 31857137
- PMCID
- PMC7177196
- NLM abbreviation
- Hum Pathol
- ISSN
- 0046-8177
- eISSN
- 1532-8392
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Pathology
- Record Identifier
- 9984183982402771
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