Quiz 12 – Diagnosis

Final Diagnosis:

 C) Neuroendocrine Neoplasm

Discussion:

Histology: Pamcreatic mass – Cytoblock (from EUS-FNA) 

 h&e

 chromogranin

 Synaptofisin

 Ki67 (MIB-1) 

Pancreatic endocrine tumors can occour at any age but are more common in older adults. Pancreatic endocrine tumors are uncommon, often are asymptomatic or present with nonspecific symptoms. There is no sex predilection. Tumors can devolop anywere within the pancreas but are more common in the pancreatic tail.

Pancreatic endocrine tumors react strongly and diffusely with antibodies to neuroendocrine tumors (Chromogranin, synaptofisin, CD56). Some investigators attempted to use ancillary studies to predict biologic behavior of these tumors based on histologic speciemens. For example, some athors have suggested measuring cellular proliferation with Ki67 immunostaining and have noted that tumors with high staining indices have a greater likehood of behaving malignanty. The clinical utlity of this assay has not yet been validated in well-controlled prospective studies.

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