Journal article
Practice Patterns for Reporting Digestive System Neuroendocrine Neoplasms: Results from a Large, Comprehensive International Survey
Histopathology, Vol.82(4), pp.541-554
03/2023
DOI: 10.1111/his.14851
PMID: 36507623
Abstract
Criteria for interpretation of digestive system neuroendocrine neoplasms (NENs) continue to evolve. Although there are some literature recommendations regarding workup and diagnosis of these lesions, different practice patterns exist among pathologists when signing out these specimens. The aim of this study was to assess practice trends among pathologists worldwide when reporting these neoplasms.
We created an online survey with multiple questions pertaining to digestive NENs. The results were analyzed based on type of practice setting, years of sign-out experience, and practice location. Respondents included 384 practicing pathologists: 70% academic, 30% private practice; 63% gastrointestinal (GI) pathology-subspecialized, 37% not; 39% North American, 42% European, 19% others; 45% with <10 years in practice; 55% with >10 years. Some question responses were chosen by the majority (e.g., 85% use both mitotic count and Ki67 index for grading NENs, 82% complete a synoptic and Ki67 stain even for small incidental appendiceal neuroendocrine tumors [NETs], and 96% utilize the diagnosis of grade 3 NET). However, some questions showed varying responses, including counting mitotic figures, Ki67 stain interpretation, and pancreatic grade 3 NEN workup. Pathologists also had some variability in interpreting regional metastatic foci of small bowel NETs and in choosing blocks for Ki67 staining in multifocal lesions.
There existed scenarios wherein practice patterns varied despite recommendations in the literature, and there were also scenarios lacking clear guidelines wherein pathologists used varying judgement. This survey highlights current key gray areas in digestive system NEN evaluation, leading to variation in practice patterns.
Details
- Title: Subtitle
- Practice Patterns for Reporting Digestive System Neuroendocrine Neoplasms: Results from a Large, Comprehensive International Survey
- Creators
- Dipti M Karamchandani - Department of Pathology, UT Southwestern Medical Center, Dallas, TXBrian Cox - Department of Pathology, Cedars Sinai Health System, Los Angeles, CAStefano La Rosa - University of InsubriaAndrew M Bellizzi - Department of Pathology, University of Iowa, Iowa City, IAChanjuan Shi - Duke UniversityRaul S Gonzalez - Emory University Hospital
- Resource Type
- Journal article
- Publication Details
- Histopathology, Vol.82(4), pp.541-554
- DOI
- 10.1111/his.14851
- PMID
- 36507623
- ISSN
- 0309-0167
- eISSN
- 1365-2559
- Language
- English
- Electronic publication date
- 12/12/2022
- Date published
- 03/2023
- Academic Unit
- Pathology
- Record Identifier
- 9984327057102771
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