皮质和胰腺中同时存在的神经内分泌瘤:临床病理学挑战
Alice Laffi1, Alexia Francesca Bertuzzi1, Silvia Carrara2
1Department of Oncology & Hematology, IRCCS, Humanitas Research Hospital, Rozzano, Milan, Italy.
Endocrine pathology
|June 7, 2024
概括
同时存在的乳腺和胰腺神经内分泌瘤 (NETs) 是罕见的. 区分初级和转移性疾病需要多学科评估和组织病理学,以适当治疗患者.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 消化神经内分泌瘤 (NENs) 包括常见的乳腺 (I) 和胰腺 (Pan) 神经内分泌瘤 (NETs).
- 在大肠和胰腺中同步或超时的NET很少发生.
- 准确确定原发性病变与转移性病变对于有效的患者管理至关重要.
研究的目的:
- 为了研究患有同时存在的乳腺和胰腺NET的患者的特征.
- 在这两个部位评估区分初级和转移性神经内分泌瘤的方法.
- 为这些罕见的双部位NEN提供最佳治疗策略.
主要方法:
- 来自ENETS卓越中心 (2012-2022) 的临床报告的回顾性审查.
- 选择患有同步或超时性乳腺和胰腺神经内分泌病变的患者.
- 在两处部位的样本上进行了基因病理和免疫组织化学 (IHC) 分析 (CDX2,Islet1,血清素).
主要成果:
- 确定了7名患有内和胰腺中NET的患者.
- 五例病例呈现同步病变;两个病例的诊断是超时的 (在INET之后是PanNET).
- 组织病理学和IHC分析揭示了三种不同的起源:胰腺转移的主要INET,胰腺转移的主要PanNET或同步的初级瘤.
结论:
- 同时存在的乳腺和胰腺NENs代表了一个罕见的临床挑战.
- 一个个案例的多学科方法对于诊断至关重要.
- 综合性组织病理学检查至关重要,以区分转移性和原发性疾病,指导治疗决策.
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