CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms: a report of 33 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Tao ,  PU Hong , CHEN Guangwen

Department of Radiology, Sichuan Academy of Medical Sciences, Sichuan Povincial People’s Hospital, Chengdu 610072, P.R.China;

Corresponding author：

PU Hong, Email: ph1726148853@qq.com

Keywords：

gastrointestinal neuroendocrine neoplasms; tomography; X-ray computed

DOI：

10.7507/1007-9424.201701008

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms (GI-NENs). Method The clinical and CT materials of 33 cases of GI-NENs who treated in our hospital from Jan. 2013 to Dec. 2015 were retrospectively analyzed. Results Of the 33 cases, 25 males and 8 females were enrolled. The median age was 62-year old (27–78 years), and the age at diagnosis mainly focused in the 50–70 years period. GI-NENs situation: 12 cases in the stomach, 11 cases in the rectum, 3 cases in the esophagus and colon respectively, 2 cases in the duodenum and appendix respectively. The main clinical symptoms included: abdominal pain in 13 cases, dysphagia and obstruction in 9 cases, hematemesis and hematochezia in 8 cases, abdominal distention in 5 cases, stool and bowel habits change in 5 cases, subxyphoid pain in 3 cases, belching in 2 cases, diarrhea in 1 case, protrusion of the neoplasm when defecation in 1 case, obstructive jaundice in 1 case. Seven cases of G1 grade, 6 cases of G2 grade, 15 cases of G3 grade, and 5 cases of mixed adenoneuroendocrine carcinomas were found according to pathologic grading. The immunohistochemical marker: synaptophsin was positive in 31 cases, cytokeratin A was positive in 23 cases, and cytokeratin was positive in 9 cases. The CT appearances of GI-NENs were mainly thickening of the walls and formation of nodules or masses in local area. Moderately homogeneous enhancement (in 20 cases) and irregularly heterogeneous enhancement (in 13 cases) were both commonly seen. In addition, 13 cases of lymphadenophathy, 6 cases of liver metastasis, and 3 cases of lung metastasis were also detected by CT. Conclusions GI-NENs have a preference for elderly male. The most common site of onset is the stomach. Its clinical symptoms and CT appearances are nonspecific, however, the enhancement pattern of the tumors has a certain characteristic.

Citation： LU Tao, PU Hong, CHEN Guangwen. CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms: a report of 33 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(6): 736-742. doi: 10.7507/1007-9424.201701008 Copy

1.	Fraenkel M, Kim MK, Faggiano A, et al. Epidemiology of gastroenteropancreatic neuroendocrine tumors. Best Pract Res Clin Gastroenterol, 2012, 26(6): 691-703.
2.	Bosman F, Carneiro F, Hruban R, et al. WHO classification of tumors of the digestive system. Lyon: IARC Press, 2010: 100-155.
3.	Yao JC, Hassan M, Phan A, et al. One hundred years after ‘carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States. J Clin Oncol, 2008, 26(18): 3063-3072.
4.	Oberg K, Akerström G, Rindi G, et al. ESMO guideline working group. Neuroendocrine gastroenteropancreatic tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2010, 21 Suppl 5: v223-v227.
5.	Lawrence B, Gustafsson BI, Chan A, et al. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am, 2011, 40(1): 1-18.
6.	Turaga KK, Kvols LK. Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin, 2011, 61(2): 112-132.
7.	Heller MT, Shah AB. Imaging of neuroendocrine tumors. Radiol Clin North Am, 2011, 49(3): 529-548.
8.	Chang S, Choi D, Lee SJ, et al. Neuroendocrine neoplasms of the gastrointestinal tract: classification, pathologic basis, and imaging features. Radiographics, 2007, 27(6): 1667-1679.
9.	Ito T, Sasano H, Tanaka M, et al. Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan. J Gastroenterol, 2010, 45(2): 234-243.
10.	郭林杰, 唐承薇. 中国胃肠胰神经内分泌肿瘤临床研究现状分析. 胃肠病学, 2012, 17(5): 276-278.
11.	唐承薇, 郭林杰. 我国胃肠胰神经内分泌肿瘤临床现状分析. 中国实用外科杂志, 2014, 34(6): 490-492.
12.	Schott M, Klöppel G, Raffel A, et al. Neuroendocrine neoplasms of the gastrointestinal tract. Dtsch Arztebl Int, 2011, 108(18): 305-312.
13.	Obernorfer S. Karzinoide tumoren des dunndarms. Frankf Z Patrol, 1907, 1(1): 426-432.
14.	Chetty R. An overview of practical issues in the diagnosis of gastroenteropancreatic neuroendocrine pathology. Arch Pathol Lab Med, 2008, 132(8): 1285-1289.
15.	Campana D, Nori F, Poscotelli L, et al. Chromogranin A: is it a useful marker of neuroendocrine tumors? J Clin Oncol, 2007, 25(15): 1967-1973.
16.	Zatelli MC, Torta M, Leon A, et al. Chromogranin A as a marker of neuroendocrine neoplasia: an Italian multicenter study. Endocr Relat Cancer, 2007, 14(2): 473-482.
17.	张瑞晓, 王琦, 武希润, 等. 胃肠胰神经内分泌肿瘤 112 例临床特点分析. 中华临床医师杂志(电子版), 2015, 9(15): 2803-2807.
18.	何云飞, 张念如, 冯仕庭, 等. 胃肠胰神经内分泌肿瘤的影像诊断进展. 国际医学放射学杂志, 2012, 35(1): 53-58.
19.	Wang D, Zhang GB, Yan L, et al. CT and enhanced CT in diagnosis of gastrointestinal neuroendocrine carcinomas. Abdom Imaging, 2012, 37(5): 738-745.
20.	Armbruster M, Sourbron S, Haug A, et al. Evaluation of neuroendocrine liver metastases: a comparison of dynamic contrast-enhanced magnetic resonance imaging and positron emission tomography/computed tomography. Invest Radiol, 2014, 49(1): 7-14.
21.	Tamm EP, Kim EE, Ng CS. Imaging of neuroendocrine tumors. Hematol Oncol Clin North Am, 2007, 21(3): 409-432.
22.	Elsayes KM, Menias CO, Bowerson M, et al. Imaging of carcinoid tumors: spectrum of findings with pathologic and clinical correlation. J Comput Assist Tomogr, 2011, 35(1): 72-80.
23.	Alexandraki KI, Kaltsas G. Gastroenteropancreatic neuroendocrine tumors: new insights in the diagnosis and therapy. Endocrine, 2012, 41(1): 40-52.
24.	Singh S, Asa SL, Dey C, et al. Diagnosis and management of gastrointestinal neuroendocrine tumors: an evidence-based Canadian consensus. Cancer Treat Rev, 2016, 47: 32-45.
25.	Ruszniewski P, Delle Fave G, Cadiot G, et al. Well-differentiated gastric tumors/carcinomas. Neuroendocrinology, 2006, 84(3): 158-164.

1. Fraenkel M, Kim MK, Faggiano A, et al. Epidemiology of gastroenteropancreatic neuroendocrine tumors. Best Pract Res Clin Gastroenterol, 2012, 26(6): 691-703.
2. Bosman F, Carneiro F, Hruban R, et al. WHO classification of tumors of the digestive system. Lyon: IARC Press, 2010: 100-155.
3. Yao JC, Hassan M, Phan A, et al. One hundred years after ‘carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States. J Clin Oncol, 2008, 26(18): 3063-3072.
4. Oberg K, Akerström G, Rindi G, et al. ESMO guideline working group. Neuroendocrine gastroenteropancreatic tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2010, 21 Suppl 5: v223-v227.
5. Lawrence B, Gustafsson BI, Chan A, et al. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am, 2011, 40(1): 1-18.
6. Turaga KK, Kvols LK. Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin, 2011, 61(2): 112-132.
7. Heller MT, Shah AB. Imaging of neuroendocrine tumors. Radiol Clin North Am, 2011, 49(3): 529-548.
8. Chang S, Choi D, Lee SJ, et al. Neuroendocrine neoplasms of the gastrointestinal tract: classification, pathologic basis, and imaging features. Radiographics, 2007, 27(6): 1667-1679.
9. Ito T, Sasano H, Tanaka M, et al. Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan. J Gastroenterol, 2010, 45(2): 234-243.
10. 郭林杰, 唐承薇. 中国胃肠胰神经内分泌肿瘤临床研究现状分析. 胃肠病学, 2012, 17(5): 276-278.
11. 唐承薇, 郭林杰. 我国胃肠胰神经内分泌肿瘤临床现状分析. 中国实用外科杂志, 2014, 34(6): 490-492.
12. Schott M, Klöppel G, Raffel A, et al. Neuroendocrine neoplasms of the gastrointestinal tract. Dtsch Arztebl Int, 2011, 108(18): 305-312.
13. Obernorfer S. Karzinoide tumoren des dunndarms. Frankf Z Patrol, 1907, 1(1): 426-432.
14. Chetty R. An overview of practical issues in the diagnosis of gastroenteropancreatic neuroendocrine pathology. Arch Pathol Lab Med, 2008, 132(8): 1285-1289.
15. Campana D, Nori F, Poscotelli L, et al. Chromogranin A: is it a useful marker of neuroendocrine tumors? J Clin Oncol, 2007, 25(15): 1967-1973.
16. Zatelli MC, Torta M, Leon A, et al. Chromogranin A as a marker of neuroendocrine neoplasia: an Italian multicenter study. Endocr Relat Cancer, 2007, 14(2): 473-482.
17. 张瑞晓, 王琦, 武希润, 等. 胃肠胰神经内分泌肿瘤 112 例临床特点分析. 中华临床医师杂志(电子版), 2015, 9(15): 2803-2807.
18. 何云飞, 张念如, 冯仕庭, 等. 胃肠胰神经内分泌肿瘤的影像诊断进展. 国际医学放射学杂志, 2012, 35(1): 53-58.
19. Wang D, Zhang GB, Yan L, et al. CT and enhanced CT in diagnosis of gastrointestinal neuroendocrine carcinomas. Abdom Imaging, 2012, 37(5): 738-745.
20. Armbruster M, Sourbron S, Haug A, et al. Evaluation of neuroendocrine liver metastases: a comparison of dynamic contrast-enhanced magnetic resonance imaging and positron emission tomography/computed tomography. Invest Radiol, 2014, 49(1): 7-14.
21. Tamm EP, Kim EE, Ng CS. Imaging of neuroendocrine tumors. Hematol Oncol Clin North Am, 2007, 21(3): 409-432.
22. Elsayes KM, Menias CO, Bowerson M, et al. Imaging of carcinoid tumors: spectrum of findings with pathologic and clinical correlation. J Comput Assist Tomogr, 2011, 35(1): 72-80.
23. Alexandraki KI, Kaltsas G. Gastroenteropancreatic neuroendocrine tumors: new insights in the diagnosis and therapy. Endocrine, 2012, 41(1): 40-52.
24. Singh S, Asa SL, Dey C, et al. Diagnosis and management of gastrointestinal neuroendocrine tumors: an evidence-based Canadian consensus. Cancer Treat Rev, 2016, 47: 32-45.
25. Ruszniewski P, Delle Fave G, Cadiot G, et al. Well-differentiated gastric tumors/carcinomas. Neuroendocrinology, 2006, 84(3): 158-164.

Previous Article
Diagnosis and treatment analysis of acute deep venous thrombosis at lower extremity of 98 aged patients
Next Article
1 例具特殊影像特征甲状腺髓样癌的诊治体会并文献复习

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms: a report of 33 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content