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Der Pathologe

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Was ist neu?

Die WHO-Klassifikation 2010 für Tumoren des Pankreas
  • J. Lüttges
Hauptreferate

Zusammenfassung

Die neue WHO Klassifikation der Tumoren des Pankreas berücksichtigt abweichend von allen anderen voraufgegangenen Editionen nun sinnvollerweise die exokrinen und neuroendokrinen Tumoren in einem WHO-Band. Nach wie vor ist das duktale Adenokarzinom das häufigste und klinisch am meisten relevante Malignom. Seine Untergruppen und Varianten werden ausführlich dargestellt, ebenso wie gemischte Karzinome. Weitere Tumoren vom duktalen Phänotyp (muzinös zystische Neoplasie, MZN, und intraduktal papillär muzinöse Neoplasie, IPMN) werden konsequent als Neoplasie gelistet mit unterschiedlichem Dysplasiegrad bis hin zum invasiven Karzinom. Eine neue Subgruppe der IPNM, die intraduktale tubulopapilläre Neoplasie (ITPN) wird charakterisiert. Seröse und azinäre Tumoren werden als Neoplasien klassifiziert mit unterschiedlichem Dysplasiegrad. Die solid-pseudopapilläre Neoplasie gilt grundsätzlich als maligne Neubildung („low grade“), da sie prinzipiell metastasierungsfähig ist. Die neuroendokrinen Neoplasien werden unterschieden in neuroendokrine Tumoren (NET) G1 und G2 und neuroendokrine Karzinome (NEC) mit hohem malignem Potenzial. Syndromale NET sind gelistet nach ihrem Hormonexpressionsmuster. Auf die Probleme im Staging bei Anwendung des TNM-Systems bzw. der AJCC/UICC-Klassifikation (American Joint Committee on Cancer/Union Internationale Contre le Cancer), die gleichermaßen für endokrine und exokrine Tumoren gilt, wird hingewiesen.

Schlüsselwörter

Pankreaskarzinom, duktales Pankreasneoplasie Neuroendokrine Tumoren Neuroendokrines Karzinom Vorläuferläsion 

What’s new?

The 2010 WHO classification for tumours of the pancreas

Abstract

The new WHO classification of tumours of the pancreas logically includes both exocrine and neuroendocrine neoplasms in one volume, thus differing from all previous editions. Ductal adenocarcinoma is still the most frequent and clinically the most relevant malignant tumour. Its subtypes and variants are described in detail, as are mixed tumours. Other ductal tumours [mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms (IPNM)] are classified as neoplasms with various grades of dysplasia up to invasive carcinoma. A new subtype of IPNM, intraductal tubulopapillary neoplasm (ITPN), has been characterized and newly added to the IPMN group. Serous and acinar tumours are classified as neoplasms with varying grades of dysplasia. Solid pseudopapillary neoplasm (SPN) is regarded as malignant (low grade) as a matter of principle because of its inherent potential to metastasize. Neuroendocrine neoplasms are characterized as G1 or G2 neuroendocrine tumours (NET) and neuroendocrine carcinomas (NEC, highly malignant). Syndromatic NETs are described and named according to their hormone expression pattern. The problems of staging when applying either the TNM or AJCC/UICC (American Joint Committee on Cancer/Union Internationale Contre le Cancer) classifications, which apply equally to endocrine and exocrine tumors, are discussed.

Keywords

Carcinoma, pancreatic ductal Pancreatic neoplasms Neuroendocrine tumors Neuroendocrine carcinoma Precursor lesion 

Notes

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Institut für PathologieKlinikum SaarbrückenSaarbrückenDeutschland

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