Saeed Omer A M, Cramer Harvey, Wang Xiaoyan, Wu Howard H
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Diagn Cytopathol. 2018 Jan;46(1):35-39. doi: 10.1002/dc.23849. Epub 2017 Oct 27.
Fine needle aspiration (FNA) is considered an excellent technique for documenting metastatic neuroendocrine tumors (NETs). This study aims to evaluate the accuracy of FNA in diagnosing metastatic NETs to the liver and determining the grade and origin of these metastases.
Our laboratory information system was searched from 1997 to 2016 to identify all cases of metastatic NETs to the liver that were sampled by FNA. The cytopathology and surgical pathology reports as well as the patients' electronic medical records were reviewed. The cytohistologic type and grade of the metastatic NETs, as well as the site of the patient's primary were recorded.
High-grade NETs, including small cell and poorly differentiated neuroendocrine carcinomas, constituted 62% (167/271) of the cases, while low-grade NETs, including well differentiated NET (grade1 and grade 2), pheochromocytomas, paragangliomas, and carcinoid tumors of lung, constituted 38% (104/271) of cases. The most common diagnosis was metastatic small cell carcinoma accounting for 45% (122/271) of cases. The most common primary sites were lung (44%; 119/271) followed by pancreas (19%; 51/271). The FNA diagnosis was confirmed by histopathology in 121 cases that had a concurrent biopsies or resection specimens.
FNA is an accurate method for diagnosing metastatic NETs to the liver. There were significantly more high-grade (62%) than low-grade (38%) metastatic NETs to the liver. In our practice, lung (44%) and pancreas (19%) were the most common primary sites of metastatic NETs involving the liver. In 16% of the cases, a primary site could not be established.
细针穿刺抽吸活检（FNA）被认为是记录转移性神经内分泌肿瘤（NETs）的一项出色技术。本研究旨在评估FNA诊断肝转移性NETs以及确定这些转移瘤的分级和来源的准确性。
检索我们实验室1997年至2016年的信息系统，以识别所有通过FNA取样的肝转移性NETs病例。回顾细胞病理学和手术病理学报告以及患者的电子病历。记录转移性NETs的细胞组织学类型和分级，以及患者原发灶的部位。
高级别NETs，包括小细胞癌和低分化神经内分泌癌，占病例的62%（167/271），而低级别NETs，包括高分化NET（1级和2级）、嗜铬细胞瘤、副神经节瘤和肺类癌肿瘤，占病例的38%（104/271）。最常见的诊断是转移性小细胞癌，占病例的45%（122/271）。最常见的原发部位是肺（44%；119/271），其次是胰腺（19%；51/271）。121例同时进行活检或切除标本的病例中，FNA诊断经组织病理学证实。
FNA是诊断肝转移性NETs的准确方法。肝转移性NETs中高级别（62%）明显多于低级别（38%）。在我们的实践中，肺（44%）和胰腺（19%）是累及肝脏的转移性NETs最常见的原发部位。16%的病例无法确定原发部位。
