Diagnosis Of Endocrine Tumors Research Articles

Bad Kits in the Diagnosis of Endocrine Tumors

Bad Kits in the Diagnosis of Endocrine Tumors

C4-P-10Three-dimensional ultrastructural analysis of secretory granules in histological paraffin sections of endocrine tumors using low-vacuum SEM

Secretory granules of endocrine tumors are traditionally identified by transmission electron microscopy of tissue samples. Recently, we developed a simple method for three-dimensional morphological analysis of conventional paraffin sections using low-vacuum scanning electron microscopy (SEM) [1], and showed that this technique was useful for pathological diagnosis of renal biopsy samples [2]. In this study, we investigated whether this method is useful as an adjunct in pathological diagnosis of endocrine tumors. Preparations were processed according to our original method. Paraffin sections (5 μm thick) obtained from a normal rat pancreas as a control, a human pituitary adenoma and a colorectal carcinoid tumor were generated by the conventional method. After deparaffinization, the sections were stained only with platinum blue aqueous solution (TI-blue staining kit: Nisshin EM, Tokyo) for 15 min at room temperature, and then observed by low-vacuum SEM (TM-1000, TM3030 plus: Hitachi, Tokyo) at high magnification (~30,000×). Under low-vacuum SEM, secretory granules of each cell could be identified as bright spherical granules in each paraffin-sectioned tissue, depending on the contrast of BSE signals. Figure shows low-vacuum SEM image (a) and TEM image (b) of endocrine secretory granules 100–260nm in diameter (arrows) in colorectal carcinoid tumor cells. Our results suggest that low-vacuum SEM of conventional paraffin sections is suitable for the pathological diagnosis of endocrine tumors. [1] Inaga et al., Arch. Histol. Cytol., 72 (2009) 101-106. [2] Okada et al., Biomed. Res., 35 (2014) 345-350. C4-P-09 doi:10.1093/jmicro/dfv327

Update on the Molecular Diagnosis of Endocrine Tumors: Toward –omics-Based Personalized Healthcare?

Genetic advances in endocrine neoplasia provided the paradigm for the practice of clinical cancer genetics: germline RET mutations in multiple endocrine neoplasia type 2. In the last 14 yr, both genetics and -omics advances have occurred, almost exponentially in the last 5 yr. The time has come to reevaluate recent advances in genomic medicine's promise to revolutionize personalized healthcare in the context of endocrine neoplasias. This update focuses on two examples of endocrine neoplasias, those of the thyroid and of the adrenal, and discusses recent advances in germline and somatic genetics and genomics, as they relate to clinical application.

Practical markers used in the diagnosis of endocrine tumors.

Endocrine tumors constitute a large group of neoplasms that are widely dispersed throughout the body. They are made up mostly of neuroendocrine tumors (NE), which are characterized by the presence of secretory granules and production of peptide hormones, and non-NE tumors such as those derived from thyroid follicular cells and adrenal cortical cells. Immunohistochemical markers have been used to characterize these lesions and distinguish them from other histologically similar tumors. Chromogranin and synaptophysin are the most widely used broad-spectrum neuroendocrine tumor markers. The use of antibodies to transcription factors, keratins, and specific peptides is quite valuable in the diagnosis of endocrine tumors. This article reviews the common markers used to characterize endocrine tumors and to recognize tumors involved in the differential diagnosis of specific lesions.

Cystic endocrine tumors of the pancreas: clinical, radiologic, and histopathologic features in 13 cases.

Cystic endocrine tumors of the pancreas are rare and raise difficult clinical problems. Our aims were to reevaluate the diagnostic and therapeutic strategy and to assess their histopathologic characteristics. Thirteen cystic endocrine tumors diagnosed in 10 patients were included. Clinical, radiologic, and pathologic data were reviewed. There were 6 male and 4 female patients (median age, 46 yrs). Six patients had evidence of multiple endocrine neoplasia type 1 (MEN1) disease. Four had a functional endocrine syndrome. Ten tumors were visible on imaging studies. The most suggestive radiologic features were the existence of a peripheral hypervascular rim (10 cases) and images of cyst into cyst (two cases). On gross and histologic examinations, two distinct types were present. Macrocystic tumors (six cases) were unilocular and limited by a thick wall containing nests of tumor cells. Microcystic tumors (seven cases) were characterized by the presence of multiple cystic spaces directly lined by tumor cells. Surgical resection was performed in all cases. Three patients had lymph node metastases at the time of diagnosis. One patient is dead with metastatic dissemination. The others are alive without recurrence or metastasis. The diagnosis of endocrine tumor must be considered for any pancreatic cyst discovered in a patient with a history of MEN1 syndrome or with clinical features suggestive of this syndrome. Cystic pancreatic endocrine tumors must be treated by surgical resection because of their possible malignant evolution.

Efficiency of percutaneous core biopsy in pancreatic tumor diagnosis

Radiologic diagnosis of pancreatic tumors exhibits limited precision. The aim of this study was to investigate the outcome and complications of pancreatic core biopsy in patients with suspected pancreatic neoplasms. One hundred patients underwent ultrasonography-guided core biopsy of 1.2 mm external diameter. Medical charts were examined for biochemical and clinical signs of complications. Final diagnosis was settled by operation, autopsy, and clinical signs of the disease including survival with at least 2.3 years of follow-up. Histopathologic biopsy evaluation showed correct discrimination between exocrine and endocrine tumors and nonneoplastic conditions in 89 patients. No false-positive cancer diagnosis was found, and guidance on nature of primary tumors was obtained for eight of eight metastases. The sensitivity was 91% for exocrine and 87% for endocrine pancreatic tumors, and negative predictive values of these diagnoses were 83% and 97%, respectively. No clinically significant complications were noted. Core biopsy is an attractive alternative to diagnostic laparotomy in unresectable pancreatic cancer and efficiently provides diagnosis of endocrine tumors and pancreatic metastases in conjunction with rare complications. Benign biopsy findings cannot be used to exclude presence of primary or metastatic pancreatic neoplasms.

Proliferation Markers and Their Uses in the Study of Endocrine Tumors.

A growing body of literature supports the view that the proliferative activity (PA) of tumor cells is an important prognostic indicator for a variety of different tumors. We examined the role of PA in diagnosis and prediction or malignancy of endocrine tumors (ETs) of pituitary gland, pancreas, thyroid, parathyroid glands, adrenal glands, paraganglia, gastroenteric tract, and lung. The data in the literature indicate that the assessment of PA is not a diagnostic indicator of malignancy especially at the individual case level, whereas it can be useful for identifying subsets of malignant tumors with different aggressiveness potential, as well as for choosing therapeutic options in metatstatic lesions. We hope that, in the near future, multiparametric approaches including PA markers, cell growth and differentiation factors, and oncogenes will yield valuable information for diagnosis and prognosis of ETs also in individual cases.

Gastroenteropancreatic tumours and prohormones.

The structures and post-translational maturation of pancreatic and gastrointestinal prohormones are reviewed with emphasis on Danish contributions to today's knowledge. The review describes general, cell-specific, and tumour-specific prohormone-processing patterns. Since prohormone-processing in endocrine tumours is often attenuated, conventional assays that measure only the phenotypic endpoint of hormone gene expression (i.e. the bioactive hormone) do not quantitate tumour activity accurately. In contrast, measurements that include also prohormones and processing intermediates provide more accurate data on hormone synthesis in gastroenteropancreatic endocrine tumours. In order to comply with such demands we have developed a new analytical principle (processing-independent analysis (PIA)) which quantitates the entire translation product irrespective of the degree of processing. The significance of PIA in routine diagnostics awaits prospective evaluation. We hope that the present review illustrates how the tumour biology of endocrine cells in the pancreas and the gut has been an essential research area in Danish gastroenterology and endocrinology--one purpose being improvement of early diagnosis of endocrine tumours in the gut and the pancreas.

Somatostatin receptor scintigraphy (SRS) in the diagnosis of endocrine tumors: Comparison with standard techniques: [formula omitted], E. Del Vecchio, R. De Giorgio, B. Bellanova∗, M. Migliori, L. Gullo, R. Corinaldesi, L. Barbara. Institute of Medical Clinic and Gastroenterology and Nuclear Medicine Department∗. University of Bologna, Italy

Somatostatin receptor scintigraphy (SRS) in the diagnosis of endocrine tumors: Comparison with standard techniques: [formula omitted], E. Del Vecchio, R. De Giorgio, B. Bellanova∗, M. Migliori, L. Gullo, R. Corinaldesi, L. Barbara. Institute of Medical Clinic and Gastroenterology and Nuclear Medicine Department∗. University of Bologna, Italy

The Role of Magnetic Resonance Imaging in the Diagnosis of Endocrine Tumours of the Seller Region in Children

Most tumours of the sellar region in children give rise to one or more of the following endocrinological symptoms; anterior pituitary hypersecretion syndromes, growth delay, diencephalic syndrome, diabetes insipidus or precocious puberty. Magnetic resonance imaging enables the visualization of tumours, providing recognizable characteristics allowing the relatively easy recognition of pituitary adenomas, craniopharyngiomas, germinomas, hamartomas, hypothalamic astrocytomas as well as granulomatous proliferations.