Neuroendocrine Tumors of Meckel's Diverticula: Rare but Fare Well

2019 ◽  
Vol 85 (10) ◽  
pp. 1125-1128 ◽  
Author(s):  
James P. De Andrade ◽  
Andrew M. Blakely ◽  
Andrew H. Nguyen ◽  
Philip H. G. Ituarte ◽  
Susanne G. Warner ◽  
...  
Keyword(s):  
Lymph Node ◽  
Neuroendocrine Tumors ◽  
Lymphovascular Invasion ◽  
Metastatic Lymph Node ◽  
National Cancer Database ◽  
Tumor Characteristics ◽  
Node Disease ◽  
Node Metastases ◽  
Well Differentiated ◽  
Common Malignancy

Neuroendocrine tumors (NETs) are the most common malignancy arising in Meckel's diverticula (MDs). To date, there are no large series characterizing these tumors. The National Cancer Database was queried for patients with MD NETs (n = 162) from 2004 to 2014. Patient and tumor characteristics as well as outcomes were analyzed. MD NETs were more common in men (72.8%) at a median age of 62 years; 95.1 per cent of patients were white. All patients underwent surgery. Clinical M0 disease was present in 97.4 per cent of patients, and 88.2 per cent of tumors were well differentiated. Lymphovascular invasion was present in 13.2 per cent. Most (60.4%) tumors were less than 10 mm. Lymphadenectomy was performed in 32.9 per cent of patients, with 52.1 per cent of these found to have metastatic lymph node disease. Although most MD NETs are well differentiated, smaller than 10 mm, and do not have lymphovascular invasion, lymph node metastases are commonly found, suggesting that mesenteric lymphadenectomy with adequate resection of the small bowel may be necessary for adequate staging and disease clearance.

236 Evaluation of PD-L1 expression in primary lung tumor and metastatic lymph nodes in the presence of immune cells

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A253-A253
Author(s):  
Chris Hansis ◽  
Xiaomei Wang ◽  
Tao Wang ◽  
Gerald Feldman
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Tumor Cells ◽  
Squamous Cell ◽  
Immune Cells ◽  
Lymph Node Metastases ◽  
Metastatic Lymph Node ◽  
Metastatic Lymph ◽  
Node Metastases

BackgroundImmunotherapies against programmed death ligand-1 (PD-L1) have been established as an effective treatment for a subset of lung cancer patients. Even though it is critical for a successful therapy to know prevalent PD-L1 expression patterns in all affected tissues, information on matching lymph node metastases and immune cells is particularly limited. The purpose of this study was thus to evaluate comparative PD-L1 expression profiles in those tissues.MethodsFDA-approved IHC assays for PD-L1 (Dako 22C3) were performed on a lung tissue array (LC814A, US Biomax) according to manufacturer’s instructions. Histopathological analysis by H-scoring was performed to determine the rate and intensity of positive tumor and immune cell staining for each of the 80 cores. The H score was calculated as follows: A total of up to 300 cells were assessed, per specimen, at 40x high-power magnification (typically over 7–10 fields). A staining level of 0–3 was then assigned to each cell, to designate the intensity of specific positive membranous-to-cytoplasmic staining. The H score was subsequently calculated as% cells staining at level 1 (x1) +% cells staining at level 2 (x2) +% cells staining at level 3 (x3) = total H score per sample. This resulted in a maximum possible H score of 300.ResultsOf the 16 adenocarcinoma tumor samples with a valid staining, 7 (44%) showed positive PD-L1 staining for tumor cells and 10 (63%) for primary immune cells. Importantly, 9 matching metastatic lymph node samples out of the 16 samples (56%) showed an increased PD-L1 H score compared to primary tumors for both tumor cells and immune cells (figure 1). Of the 15 squamous cell carcinoma samples with a valid staining, 11 (73%) showed detectable PD-L1 expression levels in the primary tumor and 12 (80%) in the primary immune cells, while 7 (47%) and 9 (60%) showed lower scores in matching metastatic lymph node tumor cells and their immune cells, respectively (figure 2). Very low or no expression of PD-L1 was detected in small cell lung cancer, as to be expected from previous studies.Abstract 236 Figure 1PD-L1 Staining in adenocarcinomaAbstract 236 Figure 2PD-L1 Staining in squamous cell carcinomaConclusionsSquamous cell carcinomas and adenocarcinomas display significant heterogeneity with regard to PD-L1 expression in associated lymph node metastases. While the reasons for this frequent discordant PD-L1 expression pattern involving both tumor and immune cells need to be investigated further, our findings may help guide the proper interpretation of PD-L1 companion diagnostic test results and subsequent therapeutic decisions.AcknowledgementsThe views in this Abstract have not been formally disseminated by the U.S. Food and Drug Administration and should not be construed to represent any agency determination or policy.

Detection of Lymphovascular Invasion in Vulvar Cancer by D2-40 (Podoplanin) as a Predictor for Inguinal Lymph Node Metastases

Onkologie ◽  
2009 ◽  
Vol 32 (12) ◽  
pp. 732-738 ◽  
Author(s):  
Michael Braun ◽  
Eva Wardelmann ◽  
Manuel Debald ◽  
Gisela Walgenbach-Bruenagel ◽  
Tobias Höller ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Lymphovascular Invasion ◽  
Vulvar Cancer ◽  
Inguinal Lymph Node ◽  
Node Metastases

Lymphovascular Invasion Predicts Lymph Node Involvement in Small Pancreatic Neuroendocrine Tumors

2019 ◽  
Vol 110 (5) ◽  
pp. 384-392 ◽  
Author(s):  
Andrew M. Blakely ◽  
Kelly J. Lafaro ◽  
Daneng Li ◽  
Jonathan Kessler ◽  
Sue Chang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Neuroendocrine Tumors ◽  
Lymphovascular Invasion ◽  
Pancreatic Head ◽  
Tumor Grade ◽  
Mitotic Rate ◽  
Endoscopic Biopsy ◽  
Pancreatic Neuroendocrine Tumors ◽  
Regional Lymphadenectomy ◽  
Node Involvement

Introduction: Pancreatic neuroendocrine tumors (p-NETS) are increasing in incidence, and prognostic factors continue to evolve. The benefit of lymphadenectomy for p-NETS ≤2 cm remains unclear. We sought to determine the significance of lymphovascular invasion (LVI) for small p-NETS. Methods: The National Cancer Database was queried for patients with p-NETS ≤2 cm and with ≥1 evaluated lymph node (LN), years 2004–2015. Demographic, clinical, and treatment characteristics were analyzed. Multivariate logistic regression was performed to identify predictors of LN positivity. Results: Among 2,499 patients identified, tumor location was delineated as the head (26%), body (18%), tail (38%), or unspecified (18%); 74% were well-differentiated versus 10% moderate, 2% poor, and 14% unknown. LVI occurred in 11%. A median of 9 LNs were evaluated; overall positivity was 18%. Mean survival was significantly longer in node-negative patients (115 vs. 95 months, log-rank p < 0.0001). LVI was the strongest predictor of node involvement (OR 10.4, p < 0.0001) when controlling for tumor size, grade, and location. Subset analysis of patients with known LVI status, grade, location, and mitoses found that LVI was more likely in the setting of moderate-to-high tumor grade, 1–2 cm size, pancreatic head location, and high mitotic rate. Among patients with ≥2 of these 4 factors, 25% were node-positive. Conclusions: Presence of LVI was the strongest predictor of node positivity. LVI on endoscopic biopsy should prompt resection and regional LN dissection to fully stage patients with small p-NETS. Patients with other high-risk factors should also be considered for resection and regional lymphadenectomy.

scholarly journals Prognostic Significance of Lymph Node Metastases in Small Intestinal Neuroendocrine Tumors

2015 ◽  
Vol 101 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Michelle Kang Kim ◽  
Richard R.P. Warner ◽  
Stephen C. Ward ◽  
Noam Harpaz ◽  
Sasan Roayaie ◽  
...  
Keyword(s):  
Lymph Node ◽  
Neuroendocrine Tumors ◽  
Lymph Node Metastases ◽  
Prognostic Significance ◽  
Node Metastases ◽  
Small Intestinal

The conundrum of < 2-cm pancreatic neuroendocrine tumors: A preoperative risk score to predict lymph node metastases and guide surgical management

Surgery ◽  
2019 ◽  
Vol 166 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Alexandra G. Lopez-Aguiar ◽  
Cecilia G. Ethun ◽  
Mohammad Y. Zaidi ◽  
Flavio G. Rocha ◽  
George A. Poultsides ◽  
...  
Keyword(s):  
Lymph Node ◽  
Surgical Management ◽  
Neuroendocrine Tumors ◽  
Risk Score ◽  
Lymph Node Metastases ◽  
Pancreatic Neuroendocrine Tumors ◽  
Preoperative Risk ◽  
Node Metastases
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