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Research ArticleOriginal Article
Open Access

Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration

An immunohistochemical study

Emad M. Raddaoui, Majid A. Almadi, Abdulrahman M. Aljebreen, Faisal A. Alsaif, Ahlam A. AlShedoukhy, Abed H. Al-Lehibi, Khalid A. Almohameed, Apostolos V. Tsolakis, Mousa A. AlAbbadi and Amna R. Almutrafi
Saudi Medical Journal July 2016, 37 (7) 744-749; DOI: https://doi.org/10.15537/smj.2016.7.14212
Emad M. Raddaoui
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
FCAP, FASC
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  • For correspondence: [email protected]
Majid A. Almadi
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MBSS, FRCPC
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Abdulrahman M. Aljebreen
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
FRCP, FACP
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Faisal A. Alsaif
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Ahlam A. AlShedoukhy
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Abed H. Al-Lehibi
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Khalid A. Almohameed
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Apostolos V. Tsolakis
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Mousa A. AlAbbadi
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
MD
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Amna R. Almutrafi
From the Division of Pathology (Raddaoui, AlShedoukhy, Almutrafi), Alfaisal University, the Division of Gastroenterology (Almadi, Aljebreen), Department of Surgery (Alsaif), College of Medicine, King Khalid University Hospital, King Saud University, the Division of Gastroenterology (Allehibi), Division of Surgery (Almohameed), King Fahad Medical City, Riyadh, the Division of Pathology (AlAbbadi), King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia, the Division of Gastroenterology (Almadi), The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada, the Department of Oncology and Pathology (Tsolakis), Karolinska Institutet, Stockholm, and the Cancer Center Karolinska (Tsolakis), Karolinska University Hospital, Stockholm, Sweden
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    Figure 1

    Pancreatic endocrine neoplasm, highly cellular aspirate composed of uniform, discohesive cells and A) revealing the typical finely distributed “salt-and-pepper” chromatin, Pap Stain (50x), B) Immunohistochemistry stains performed on cellblock showed that tumor cells are positive for synaptophysin, IHC stain (40x), C) with membranous positivity for E-cadherin, IHC stain (40x), D) IHC staining for B-catenin revealed membranous/cytoplasmic distribution with clear absence of nuclear staining, IHC stain (40x). IHC - immunohistochemical

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    Figure 2

    Solid pseudopapillary neoplasm, cellular smear with loose clusters as well as scattered well-formed papillary structures. A) The cells have delicate to clear cytoplasm and bland nuclei with fine chromatin, Pap stain (40x), B) Immunohistochemistry stains obtained on cellblock preparation showed that tumor cells are positive for B-catenin, nuclear pattern, IHC stain (40x), and C) Same cells are negative for E-cadherin, IHC stain (40x). IHC - immunohistochemical

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Saudi Medical Journal: 37 (7)
Saudi Medical Journal
Vol. 37, Issue 7
1 Jul 2016
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Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration
Emad M. Raddaoui, Majid A. Almadi, Abdulrahman M. Aljebreen, Faisal A. Alsaif, Ahlam A. AlShedoukhy, Abed H. Al-Lehibi, Khalid A. Almohameed, Apostolos V. Tsolakis, Mousa A. AlAbbadi, Amna R. Almutrafi
Saudi Medical Journal Jul 2016, 37 (7) 744-749; DOI: 10.15537/smj.2016.7.14212

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Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration
Emad M. Raddaoui, Majid A. Almadi, Abdulrahman M. Aljebreen, Faisal A. Alsaif, Ahlam A. AlShedoukhy, Abed H. Al-Lehibi, Khalid A. Almohameed, Apostolos V. Tsolakis, Mousa A. AlAbbadi, Amna R. Almutrafi
Saudi Medical Journal Jul 2016, 37 (7) 744-749; DOI: 10.15537/smj.2016.7.14212
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