title: Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis.
abstract: OBJECTIVE
  To reveal better diagnostic markers for differentiating neuroendocrine tumor (NET) from solid-pseudopapillary neoplasm (SPN), focusing primarily on immunohistochemical analysis.
  
  
  METHODS
  We reviewed 30 pancreatic surgical specimens of NET (24 cases) and SPN (6 cases). We carried out comprehensive immunohistochemical profiling using 9 markers: Synaptophysin, chromogranin A, pan-cytokeratin, E-cadherin, progesterone receptor, vimentin, α-1-antitrypsin, CD10, and β-catenin.
  
  
  RESULTS
  E-cadherin staining in NETs, and nuclear labeling of β-catenin in SPNs were the most sensitive and specific markers. Dot-like staining of chromogranin A might indicate the possibility of SPNs rather than NETs. The other six markers were not useful because their expression overlapped widely between NETs and SPNs. Moreover, two cases that had been initially diagnosed as NETs on the basis of their morphological features, demonstrated SPN-like immunohistochemical profiles. Careful diagnosis is crucial as we actually found two confusing cases showing disagreement between the tumor morphology and immunohistochemical profiles.
  
  
  CONCLUSIONS
  E-cadherin, chromogranin A, and β-catenin were the most useful markers which should be employed for differentiating between NET and SPN.
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Yusuke
authors: Y
authors: Ohara
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Tatsuya
authors: T
authors: Oda
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Shinji
authors: S
authors: Hashimoto
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Yoshimasa
authors: Y
authors: Akashi
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Ryoichi
authors: R
authors: Miyamoto
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Tsuyoshi
authors: T
authors: Enomoto
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Kaishi
authors: K
authors: Satomi
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Yukio
authors: Y
authors: Morishita
authors: Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto, Yoshimasa Akashi, Ryoichi Miyamoto, Tsuyoshi Enomoto, Nobuhiro Ohkohchi, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan.
authors: Nobuhiro
authors: N
authors: Ohkohchi
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD; D015820:Cadherins / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology*; D053379:Chromogranin A / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000378:metabolism; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011980:Receptors, Progesterone / Q000378:metabolism; D016708:Synaptophysin / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism; D055815:Young Adult; D000515:alpha 1-Antitrypsin / Q000378:metabolism; D051176:beta Catenin / Q000378:metabolism
chemical_list: D015703:Antigens, CD; C513384:CDH1 protein, human; C495270:CTNNB1 protein, human; D015820:Cadherins; D053379:Chromogranin A; D011980:Receptors, Progesterone; C569014:SYP protein, human; D016708:Synaptophysin; D014746:Vimentin; D000515:alpha 1-Antitrypsin; D051176:beta Catenin; D007633:Keratins; D015260:Neprilysin
keywords: Diagnosis; Immunohistochemistry; Neuroendocrine tumor; Pancreas; Solid-pseudopapillary neoplasm