Recent Articles on Pancreatobiliary #Pathology – 2020-07-17

These are the recent articles on Pancreatobiliary Pathology:

To see all journal watch articles please visit: http://pbpath.org/journal-watch-upcoming-issue/

New Pancreas Articles


  • Immunohistochemical distinction of paragangliomas from epithelial neuroendocrine tumors – Gangliocytic duodenal and cauda equina paragangliomas align with epithelial neuroendocrine tumors

Human pathology 2020 Jul;():

PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=32668278

Distinction of paraganglioma (PGL) from epithelial neuroendocrine tumors (NETs) can be difficult as they can mimic each other by nested architecture and expression of neuro-endocrine markers. In this study we examined differential diagnostic markers in 262 PGLs (142 adrenal pheochromocytomas and 120 extra-adrenal PGLs), 9 duodenal gangliocytic PGLs and 3 cauda equina PGLs, and 286 NETs (81 GI, 78 pancreatic, 42 thoracic, 37 medullary thyroid carcinomas, and 48 high-grade NETs including 32 small cell carcinomas of lung). While keratin-expression was nearly uniform in NETs with the exception of few tumors, extensive keratin expression was seen in only one PGL (90% of PGLs but only in 2% of NETs, usually focally. Tyrosine hydroxylase (TH) was expressed in >90% of adrenal, abdominal, and thoracic PGLs but only in 37% of head and neck PGLs reflecting their variable catecholamine synthesis. Focal or occasional extensive TH-expression was detected in 10% of NETs. CDX2 was a helpful discriminator seen in 28% of pancreatic and most GI NETs but in no PGLs. SOX10 detected sustentacular cells in 85% of PGLs and 7% of NETs, while GFAP detected sustentacular cells mainly in PGLs of neck and was absent in NETs. Duodenal gangliocytic PGLs (n = 9) and all cauda equina PGLs (n = 3) expressed keratins, lacked GATA3, showed no or minimal TH expression as some NETs, and contained SOX10 and S100 protein-positive spindle cells negative for GFAP. Ganglion-like epithelioid cells were keratin-positive and negative for TH and SOX10 differing from true ganglion cells. We conclude that duodenal gangliocytic and cauda equina PGLs have a NET-like immunoprofile and differ from ordinary PGLs. NETs can be distinguished from PGLs by their expression of keratins and general lack of GATA3, TH, and GFAP-positive sustentacular cells, and sometimes by expression of CDX2 or TTF1.

doi: https://doi.org/10.1016/j.humpath.2020.07.010



  • Pancreatic neuroendocrine tumors with somatostatin expression and paraganglioma-like features

Human pathology 2020 Jul;():

PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=32668277

A small fraction of pancreatic neuroendocrine tumors (PanNETs) shows a solid, paraganglioma-like (PG-like) histology. We wanted to know whether these PanNETs have a special hormone expression and are related to paragangliomas/pheochromocytomas (PG/PC). We screened a series of 48 surgically resected PanNETs for their histological growth patterns and their association with expression of islet-hormones. The PanNETs were divided into PG-like and non PG-like tumors and immunohistochemically monitored for the expression of islet hormones, cytokeratins and S100. The results were correlated to histological pattern, lymph node status and data in 28 PG/PCs, including 2 PGs attached to the pancreas. All PanNETs, in contrast to PGs/PCs, were cytokeratin positive. A PG-like growth pattern was identified in 9/48 PanNETs and correlated with somatostatin expression. Only half of the non PG-like PanNETs also contained somatostatin positive cells. Eight/28 PG/PCs expressed somatostatin, mostly in individual cells. PG-like PanNETs as well as non PG-like PanNETs infiltrated the adjacent pancreatic tissue, while 2 to the pancreas associated PGs were well demarcated. Lymph node metastases were detected in 58%, 39%, 57% and 53% of the somatostatin-producing, somatostatin-negative, PG-like and non-PG-like PanNETs. PG-like PanNETs, in contrast to PG/PCs, are characterized by the expression of cytokeratin and somatostatin, the development of lymph node metastasis and the infiltration into pancreatic parenchyma. Non PG-like PanNETs may also express somatostatin and show to the same extent lymph node metastases. A literature review of cases reported as PG of the pancreas reveals that only a small fraction of these tumors probably represents true pancreatic PGs.

doi: https://doi.org/10.1016/j.humpath.2020.07.004


New GallBladder Articles

Today there is no new Gallbladder Article.

New BileDuct Articles

Today there is no new Bile Duct Article.

New Ampulla Articles

Today there is no new Ampulla Article.

To see all journal watch articles please visit: http://pbpath.org/journal-watch-upcoming-issue/