Abstract:
The most recent WHO classification of endocrine and neuroendocrine tumours has brought about significant changes in the diagnosis and grading of these lesions. For instance, pathologists now have the ability to stratify subsets of thyroid and adrenal neoplasms using various histological features and composite risk assessment models. Moreover, novel recommendations on how to approach endocrine neoplasia involve additional immunohistochemical analyses, and the recognition and implementation of these key markers is essential for modernising diagnostic capabilities. Additionally, an improved understanding of tumour origin has led to the renaming of several entities, resulting in the emergence of terminology not yet universally recognised. The adjustments in nomenclature and prognostication may pose a challenge for the clinical team, and care providers might be eager to engage in a dialogue with the diagnosing pathologist, as treatment guidelines have not fully caught up with these recent changes. Therefore, it is crucial for a surgical pathologist to be aware of the knowledge behind the implementation of changes in the WHO classification scheme. This review article will delve into the most significant diagnostic and prognostic changes related to lesions in the parathyroid, thyroid, adrenal glands and the gastroenteropancreatic neuroendocrine system. Additionally, the author will briefly share his personal reflections on the clinical implementation, drawing from a couple of years of experience with these new algorithms.
摘要:
WHO对内分泌和神经内分泌肿瘤的最新分类使这些病变的诊断和分级发生了重大变化。例如,病理学家现在能够使用各种组织学特征和复合风险评估模型对甲状腺和肾上腺肿瘤的亚群进行分层.此外,关于如何治疗内分泌肿瘤的新建议涉及额外的免疫组织化学分析,识别和实施这些关键标记对于现代化诊断能力至关重要。此外,对肿瘤起源的理解的提高导致了几个实体的重命名,导致尚未得到普遍认可的术语的出现。术语和预后的调整可能对临床团队构成挑战,护理提供者可能渴望与诊断病理学家进行对话,因为治疗指南还没有完全赶上这些最近的变化。因此,对于外科病理学家来说,了解实施WHO分类方案变化背后的知识至关重要.这篇综述文章将探讨与甲状旁腺病变相关的最重要的诊断和预后变化,甲状腺,肾上腺和胃肠胰腺神经内分泌系统。此外,作者将简要分享他对临床实施的个人思考,从这些新算法的几年经验中汲取。