Surgical Pathology Criteria

Poorly Differentiated Pancreatic Neuroendocrine Carcinoma

Definition

Alternate/Historical Names

Diagnostic Criteria

Differential Diagnosis

Large Cell Poorly Differentiated Pancreatic Neuroendocrine Carcinoma Well Differentiated Pancreatic Neuroendocrine (Islet Cell) Tumor
Mitotic rate >20/10 hpf Mitotic rate not over 20/10 hpf
May have extensive necrosis Lacks extensive necrosis
Small cell poorly differentiated neuroendocrine carcinoma bears no resemblance to well differentiated neuroendocrine neoplasm

Acinar Cell Carcinoma of the Pancreas Poorly Differentiated Pancreatic Neuroendocrine (Islet Cell) Tumor
Granular PASd+ cytoplasm PASd negative
BCL10, trypsin, chymotrypsin positive BCL10, trypsin, chymotrypsin negative
Stromal fibrosis rare Frequent fibrotic stroma
Synaptophysin and chromogranin positivity <25% in pure tumors, mixed tumors may have more Synaptophysin or chromogranin positivity widespread, over 25%

Metastasis from a distant site or direct extension from duodenum

Staging

Classification / Lists

Pancreatic Carcinomas

Pancreatic Endocrine Tumors

Bibliography

Author / Update

Reetesh Pai MD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting/updates : 2/1/08, 6/18/10, 1/1/12, 1/16/13

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