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Cyto-histology in NET: what is necessary today and what is the future?

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Abstract

The carcinoid as originally described is part of the relatively large family of neuroendocrine neoplasia found in almost every organ. Historical reasons back their current definitions. Neuroendocrine cancer is most frequently observed in the lung and the digestive tract. In the lung is defined as carcinoid (typical and atypical) for well differentiated, low to intermediate grade, and small cell and large cell neuroendocrine carcinoma for poorly differentiated, high grade. In the digestive system are respectively defined as neuroendocrine tumor (NET) and neuroendocrine carcinoma (NEC) of small and large cell types. Grading and staging are developed for their clinical classification by the World Health Organization (WHO) and the American Joint Committee on Cancer (AJCC). In both anatomical sites the morphological features are overlapping, with bland histology for carcinoid and NET, and aggressive features with extensive necrosis, severe atypia and abundant, atypical mitoses for high grade cancer types. Such features are also essential diagnostic clues in cytological preparations. The confirmation of the neuroendocrine signature by immunohistochemistry is mandatory for the diagnosis; a minimum panel comprising chromogranin A and synaptophysin is recommended in the digestive system. In addition, the application of grading requires the mitotic count and or spotty necrosis assessment for lung, or the mitotic count and the Ki67 assessment in the digestive system.

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Funding

In part supported by internal university grants (Università Cattolica line D.1 2014–70,201,266) and by the Associazione Italiana Ricerca sul Cancro - AIRC IG 2013 14,696 to GR. The funders had no role in the study design and data analysis.

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  1. Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore-Fondazione Policlinico Universitario Agostino Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy

    Frediano Inzani, Gianluigi Petrone, Guido Fadda & Guido Rindi

  2. Roma European NeuroEndocrine Tumor Society (ENETS) Center of Excellence, Rome, Italy

    Frediano Inzani, Gianluigi Petrone, Guido Fadda & Guido Rindi

  3. Institute of Anatomic Pathology, Università Cattolica – Policlinico A. Gemelli, Largo A. Gemelli, 8, I-00168, Rome, Italy

    Guido Rindi

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  1. Frediano Inzani
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Correspondence to Guido Rindi.

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GR declares that he has received speaker’s fee by Novartis Pharma and Ipsen Pharma. All remaining authors have declared no conflicts of interest.

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Inzani, F., Petrone, G., Fadda, G. et al. Cyto-histology in NET: what is necessary today and what is the future?. Rev Endocr Metab Disord 18, 381–391 (2017). https://doi.org/10.1007/s11154-017-9428-x

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