Sandbox:Hannan1


Neuroendocrine tumor		Clinical manifestations		Dianosis						Gold standard	Other features
Neuroendocrine tumor		Symptoms	Signs	Blood & Urine	Gross	Histology	Immunohistochemistry	Imaging	Others	Gold standard	Other features
Medullary thyroid carcinoma^[1]^[2]^[3]		Dysphagia Hoarseness Respiratory difficulty Flushing Diarrhea Weight loss	Palpable neck mass Signs of Cushing syndrome	↑ Calcitonin ↑ Serum calcium ↑ or - Cortisol ↑ CEA level	White or gray in color Firm to palpation	Nests of uniform cells Deposition of stromal amyloid Granular chromatin C-cell hyperplasia	Calcitonin Chromogranin A Carcinoembryonic antigen (CEA)	Solid thyroid nodule (US) CT scan/MRI and PET scan for metastatis	Genetic testing	FNA cytology with immunohisto- chemistry and calcitonin levels	Associated with MEN 2A and 2B Familial association with RET mutations May present as Cushing syndrome
Pheochromocytoma^[4]^[5]^[6]^[7]		Headaches Palpitations Excessive sweating Anxiety Pallor Pain in chest/abdomen Weakness, fatigue Nausea/vomiting Dizziness Paresthesias Constipation (rarely diarrhea) Visual disturbance	Hypertension Postural hypotension Tachycardia or reflex bradycardia Tremulousness Pallor Flushing (rare) Weight loss Fasting hyperglycaemia Decreased GI motility Pallor ↑ Respiratory rate Psychosis	↑ Plasma and urine catecholamines ↑ Plasma and urine metanephrines ↑ Chromogranin A ↑ Plasma methoxytyramine	N/A	Loosely cohesive clusters Scattered tumor cells with prominent anisokaryosis, abundant eosinophilic granular cytoplasm and indistinct cell borders Occasional binucleate cells	Chromogranin A (CGA) Protein gene product (PGP) 9.5 Synaptophysin (SYN) CD56 (also known as neural cell adhesion molecule or N-CAM) Glial fibrillary acidic protein (GFAP)	Heterogeneous appearance, often with some cystic areas. Calcifications or hemorrhage may also be present (CT) T2-bright lesions, with/without cystic or necrotic components (MRI) Cystic or solid with necrotic areas or hemorrhages (U/S)	Genetic testing Provacative glucagon test Clonidine suppression test Metaiodobenzyl-guanidine scintigraphy PET scan Octereoscan	Plasma and urine catecholamines & metanephrines combined with clinical findings	May mimic panic attack May be associated with Von Hippel-Lindau disease, MEN type 2 and Neurofibromatosis type 1. Arise from the chromaffin cells
Merkel cell carcinoma^[8]^[9]^[10]		Asymptomatic red-to-violet nodules	Violaceous nodule Ulcerated Nodule Lympadenopathy	Seropositivity for Merkel cell polyomavirus Anti-ST antibodies	Dermal and subcutaneous nodule	Monomorphic cells with 3 main types — small-cell, trabecular and intermediate May show necrosis & pleomorphism Epidermotropism	Chromogranin-A Synaptophysin Cytokeratin 20 (CK20) Merkel cell polyomavirus (MCPyV) large T antigen	U/S, CT scan, MRI and PET scan for metastasis	N/A	Biopsy with immunohisto-chemistry	Higher mortality than melanoma ↑ Risk in immun-compromised
Parathyroid adenoma^[11]^[12]^[13]		Depression Memory loss Fatigue Sleep problems Bone or muscle pains GERD ↓ concentration Renal colic Constipation	Nephrolithiasis Nephrocalcinosis osteopenia osteoporosis	↑ Serum and urinary Calcium ↑ or N/L PTH	Enlarged smooth Soft Reddish brown in color	Discrete with thin fibrous capsule May be multinodular and irregular Proliferation of a single cell type with solid to pseudo-glandular, follicular, and acinar structure	Chromogranin Parathyroid hormone	Enlarged gland on U/S and ^99mTc-sestamibi scintigraphy Single photon emission computed tomography	Staining for bcl-1 Ki67 p27 parafibromin	Biopsy	Associated with MEN Associated with HPRT
Paraganglioma		Headaches Palpitations Tinnitus Decreased hearing Localized pain GI & intracranial hemorrhage Cardiomyopathy Generalized weakness	Pallor Hypertension Localized mass Orthostasis Incidentalomas Cranial nerve palsies		Clear margins Encapsulated	Honeycomb or nests patterns separated by broad bands of fibrous tissue Prominent vascularization Argyrophilic fibers	Chromogranin A Synaptophysin CD56 S-100 Cytokeratin	Mass with an un-enhanced density Internal Hemorrhage Cystic changes Necrosis Internal calcifications
Pituitary gland tumors
Neuroendocrine tumors of the ovaries or testicles
Thymic neuroendocrine cancer
Lung neuroendocrine tumors	Typical carcinoid tumours
	Atypical carcinoid tumours
	Large cell lung neuroendocrine carcinomas
	Small cell lung neuroendocrine carcinomas
Pancreatic neuroendocrine tumours	Gastrinoma
	Insulinoma
	Glucagonoma
	Somatostatinoma
	VIPoma
	ACTHoma
Gastric neuroendocrine tumors	Type I GNET
	Type II GNET
	Type III GNET
	Type IV GNET
Duodenal neuroendocrine tumors	Gastrinomas
	Somatostatinomas
	Gangliocytic paraganglionomas
	Nonfunctioning NET
	neuroendocrine carcinomas
Jejuno-Ileal neuroendocrine tumors
Appendix neuroendocrine tumors
Colon neuroendocrine tumors
Rectum neuroendocrine tumors

References

↑ Segura S, Ramos-Rivera G, Suhrland M (2018). "Educational Case: Endocrine Neoplasm: Medullary Thyroid Carcinoma". Acad Pathol. 5: 2374289518775722. doi:10.1177/2374289518775722. PMC 6024338. PMID 29978018.
↑ Roy M, Chen H, Sippel RS (2013). "Current understanding and management of medullary thyroid cancer". Oncologist. 18 (10): 1093–100. doi:10.1634/theoncologist.2013-0053. PMC 3805151. PMID 24037980.
↑ Chen H, Sippel RS, O'Dorisio MS, Vinik AI, Lloyd RV, Pacak K (August 2010). "The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer". Pancreas. 39 (6): 775–83. doi:10.1097/MPA.0b013e3181ebb4f0. PMC 3419007. PMID 20664475.
↑ Martucci VL, Pacak K (2014). "Pheochromocytoma and paraganglioma: diagnosis, genetics, management, and treatment". Curr Probl Cancer. 38 (1): 7–41. doi:10.1016/j.currproblcancer.2014.01.001. PMC 3992879. PMID 24636754.
↑ Kantorovich V, Pacak K (2010). "Pheochromocytoma and paraganglioma". Prog. Brain Res. 182: 343–73. doi:10.1016/S0079-6123(10)82015-1. PMC 4714594. PMID 20541673.
↑ Miller AD, Masek-Hammerman K, Dalecki K, Mansfield KG, Westmoreland SV (November 2009). "Histologic and immunohistochemical characterization of pheochromocytoma in 6 cotton-top tamarins (Saguinus oedipus)". Vet. Pathol. 46 (6): 1221–9. doi:10.1354/vp.09-VP-0022-M-FL. PMID 19605896.
↑ Kantorovich V, Eisenhofer G, Pacak K (December 2008). "Pheochromocytoma: an endocrine stress mimicking disorder". Ann. N. Y. Acad. Sci. 1148: 462–8. doi:10.1196/annals.1410.081. PMC 2693284. PMID 19120142.
↑ Becker JC, Stang A, DeCaprio JA, Cerroni L, Lebbé C, Veness M, Nghiem P (October 2017). "Merkel cell carcinoma". Nat Rev Dis Primers. 3: 17077. doi:10.1038/nrdp.2017.77. PMC 6054450. PMID 29072302.
↑ Han SY, North JP, Canavan T, Kim N, Yu SS (December 2012). "Merkel cell carcinoma". Hematol. Oncol. Clin. North Am. 26 (6): 1351–74. doi:10.1016/j.hoc.2012.08.007. PMID 23116583.
↑ Amaral T, Leiter U, Garbe C (December 2017). "Merkel cell carcinoma: Epidemiology, pathogenesis, diagnosis and therapy". Rev Endocr Metab Disord. 18 (4): 517–532. doi:10.1007/s11154-017-9433-0. PMID 28916903.
↑ Wieneke JA, Smith A (December 2008). "Parathyroid adenoma". Head Neck Pathol. 2 (4): 305–8. doi:10.1007/s12105-008-0088-8. PMID 20614300.
↑ Madkhali T, Alhefdhi A, Chen H, Elfenbein D (2016). "Primary hyperparathyroidism". Ulus Cerrahi Derg. 32 (1): 58–66. doi:10.5152/UCD.2015.3032. PMC 4771429. PMID 26985167.
↑ Costa-Guda J, Arnold A (April 2014). "Genetic and epigenetic changes in sporadic endocrine tumors: parathyroid tumors". Mol. Cell. Endocrinol. 386 (1–2): 46–54. doi:10.1016/j.mce.2013.09.005. PMC 3943641. PMID 24035866.

[pmid29978018-1] Segura S, Ramos-Rivera G, Suhrland M (2018). "Educational Case: Endocrine Neoplasm: Medullary Thyroid Carcinoma". Acad Pathol. 5: 2374289518775722. doi:10.1177/2374289518775722. PMC 6024338. PMID 29978018.

[pmid24037980-2] Roy M, Chen H, Sippel RS (2013). "Current understanding and management of medullary thyroid cancer". Oncologist. 18 (10): 1093–100. doi:10.1634/theoncologist.2013-0053. PMC 3805151. PMID 24037980.

[pmid20664475-3] Chen H, Sippel RS, O'Dorisio MS, Vinik AI, Lloyd RV, Pacak K (August 2010). "The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer". Pancreas. 39 (6): 775–83. doi:10.1097/MPA.0b013e3181ebb4f0. PMC 3419007. PMID 20664475.

[pmid24636754-4] Martucci VL, Pacak K (2014). "Pheochromocytoma and paraganglioma: diagnosis, genetics, management, and treatment". Curr Probl Cancer. 38 (1): 7–41. doi:10.1016/j.currproblcancer.2014.01.001. PMC 3992879. PMID 24636754.

[pmid20541673-5] Kantorovich V, Pacak K (2010). "Pheochromocytoma and paraganglioma". Prog. Brain Res. 182: 343–73. doi:10.1016/S0079-6123(10)82015-1. PMC 4714594. PMID 20541673.

[pmid19605896-6] Miller AD, Masek-Hammerman K, Dalecki K, Mansfield KG, Westmoreland SV (November 2009). "Histologic and immunohistochemical characterization of pheochromocytoma in 6 cotton-top tamarins (Saguinus oedipus)". Vet. Pathol. 46 (6): 1221–9. doi:10.1354/vp.09-VP-0022-M-FL. PMID 19605896.

[pmid19120142-7] Kantorovich V, Eisenhofer G, Pacak K (December 2008). "Pheochromocytoma: an endocrine stress mimicking disorder". Ann. N. Y. Acad. Sci. 1148: 462–8. doi:10.1196/annals.1410.081. PMC 2693284. PMID 19120142.

[pmid29072302-8] Becker JC, Stang A, DeCaprio JA, Cerroni L, Lebbé C, Veness M, Nghiem P (October 2017). "Merkel cell carcinoma". Nat Rev Dis Primers. 3: 17077. doi:10.1038/nrdp.2017.77. PMC 6054450. PMID 29072302.

[pmid23116583-9] Han SY, North JP, Canavan T, Kim N, Yu SS (December 2012). "Merkel cell carcinoma". Hematol. Oncol. Clin. North Am. 26 (6): 1351–74. doi:10.1016/j.hoc.2012.08.007. PMID 23116583.

[pmid28916903-10] Amaral T, Leiter U, Garbe C (December 2017). "Merkel cell carcinoma: Epidemiology, pathogenesis, diagnosis and therapy". Rev Endocr Metab Disord. 18 (4): 517–532. doi:10.1007/s11154-017-9433-0. PMID 28916903.

[pmid20614300-11] Wieneke JA, Smith A (December 2008). "Parathyroid adenoma". Head Neck Pathol. 2 (4): 305–8. doi:10.1007/s12105-008-0088-8. PMID 20614300.

[pmid26985167-12] Madkhali T, Alhefdhi A, Chen H, Elfenbein D (2016). "Primary hyperparathyroidism". Ulus Cerrahi Derg. 32 (1): 58–66. doi:10.5152/UCD.2015.3032. PMC 4771429. PMID 26985167.

[pmid24035866-13] Costa-Guda J, Arnold A (April 2014). "Genetic and epigenetic changes in sporadic endocrine tumors: parathyroid tumors". Mol. Cell. Endocrinol. 386 (1–2): 46–54. doi:10.1016/j.mce.2013.09.005. PMC 3943641. PMID 24035866.

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Sandbox:Hannan1

References

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