Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration: An immunohistochemical study

Authors

• Emad M. Raddaoui, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Majid A. Almadi, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Abdulrahman M. Aljebreen, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Faisal A. Alsaif, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Ahlam A. AlShedoukhy, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Abed H. Al-Lehibi, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Khalid A. Almohameed, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Apostolos V. Tsolakis, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Mousa A. AlAbbadi, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
• Amna R. Almutrafi, From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden

Abstract

Objectives: To evaluate the role of applying a limited panel of immunohistochemical stains on the cellblock preparation from samples obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the aim of differentiating solid pseudopapillary neoplasms (SPNs) from neuroendocrine tumors (NETs). Methods: We retrospectively retrieved all the EUS-FNAs of the pancreas that have a diagnosis of NET or SPN that were performed at 2 tertiary care hospitals in Riyadh, Kingdom of Saudi Arabia from May 2004 to December 2014. Diff-Quik, Papanicolaou, and Immunohistochemistry stains on cellblock preparations were performed. Results: Twenty cases were available (16 pancreatic neuroendocrine tumors (pNETs) and 4 SPNs). The pNETs were immunoreactive for synaptophysin, chromogranin A and CD56 while E-cadherin was diffusely to focally cytoplasmic positive. β-catenin was negative or showed focal cytoplasmic immunoreactivity. In comparison, SPNs were positive for vimentin, CD10, CD-56, focally positive for progesterone receptors and synaptophysin, and revealed nuclear immunostaining for β-catenin. They were negative for chromogranin A and E-cadherin. Conclusion: Based on EUS-FNA samples, nuclear immunoreactivity for β-catenin with loss of membranous immunostaining for E-Cadherin can potentially facilitate differentiating SPNs from pNETs.

Article Type

Research Article

First Page

744

Last Page

749

Recommended Citation

Raddaoui, Emad M.; Almadi, Majid A.; Aljebreen, Abdulrahman M.; Alsaif, Faisal A.; AlShedoukhy, Ahlam A.; Al-Lehibi, Abed H.; Almohameed, Khalid A.; Tsolakis, Apostolos V.; AlAbbadi, Mousa A.; and Almutrafi, Amna R. (2016) "Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration: An immunohistochemical study," Saudi Medical Journal: Vol. 37: Iss. 7, Article 5.
DOI: https://doi.org/10.15537/smj.2016.7.14212