Neuroendocrine Tumors😊

Neuroendocrine Tumors

 

• Pheochromocytoma

• Paraganglioma

• Carcinoid tumor

• Carotid body tumor





• Lyre sign on angiography : Splaying of carotids.

• Highly vascular tumor.

• Small cell carcinoma of lung

• Most functional Pancreatic tumor → Insulinoma

• Medullary Carcinoma Thyroid

Imaging

• Best → PET >> MRI

Microscopy:

• Nesting pattern (Zellballen pattern)
• Cells within a Nest
• Fibrous septa (Lined by flattened sustentacular cells)
• Speckled chromatin (Salt and pepper chromatin)

Two types of cells within nests:

1. Chief cells:
• Main neuroendocrine cells 
• Neuroendocrine markers:
• Synaptophysin
• Chromogranin
• Bombesin
• CD56, CD57,
• NSE
• New marker for NET:
• INSM1 (nuclear)
• Mnemonic:
• NET (NET) ittu pidichu → Bombitt () sincheyth () 56, 57 () vayssulla alkkare kollunnu → To Nicely (NSE) End Colorful (chromogranin) Insan (INSM1)

2. Sustentacular cells:
• Supporting cells,
• S100 positive.

Electron Microscopy:

• Shows dense neurosecretory granules (black granules).

Mnemonic:

• Selven (Zellballen pattern) Chrome (Feochromo) use cheythapo Net (NET) poi

• Chief (chief cells) avane suspend (sustentacular cells) cheyythu 100 (s100) divasathekk

• Para vachatha (Paraganglioma)

• Pullikk Small (Small cell) car (Carcinoid, Carotid body) ee ollu

• Pullikk oru PET (PET) um ind