Do morphologic characteristics play a role in nodal metastatic progression of well-differentiated pancreatic neuroendocrine tumors?

BACKGROUND

Pancreatic neuroendocrine neoplasms (NENs) are tumors with histopathologic and prognostic heterogeneity that pose difficulties in establishing standards for diagnosis, classification, and treatment. Among NENs, well-differentiated neuroendocrine tumors (NETs) have been classified as grade 1, 2, and 3 in the most recently released World Health Organization classification. Although well-differentiated NETs are associated with relatively better prognosis, they have a potential for malignant behavior such as extrapancreatic spread, metastasis, or recurrence. The present study aimed to evaluate clinical and histomorphologic findings of patients with well-differentiated pancreatic NETs and to identify histopathologic findings effective in predicting nodal metastatic progression.

METHODS

The study group consisted of 54 patients diagnosed with well-differentiated NET. All preparations and blocks of the patients were examined for the following histopathologic parameters: tumor diameter, microscopic tumor growth pattern (solid, trabecular, acinar, and mixed), cellular features (clear, eosinophilic, oncocytic, peliotic, and pseudopapillary), stromal changes (calcification, lymphocytic infiltration, and stromal hyalinization), presence of necrosis, perineural invasion, lymphovascular invasion, mitotic activity, and Ki67 proliferative index.

RESULTS

Lymph node metastasis was present in 7 patients. Lymph node metastasis was significantly associated with tumor diameter of >2 cm (p = 0.012), Ki67 proliferative index of >20% (p = 0.022), grade 3 tumors (p = 0.002), presence of dense stromal hyalinization (p = 0.034), and mild lymphocytic infiltration (p = 0.041).

CONCLUSION

The present study revealed that the new findings such as presence of dense stromal hyalinization and absence of remarkable lymphocytic infiltration could be predictive morphologic findings for the development of lymph node metastasis.

Phyllodes Tumor of the Breast: A Clinicopathological Evaluation of 55 Cases

OBJECTIVE

Phyllodes tumors are biphasic tumors consisting of epithelial and stromal components that account for less than 1% of all breast tumors. According to the World Health Organization (WHO) phyllodes tumors are classified into three categories as benign, borderline and malignant. It has been reported that these tumors are usually benign and both the stromal component and the epithelial component may progress to malignancy. In this descriptive study, it was aimed to present the cases of phyllodes tumor and to evaluate the clinicopathological features of these tumors in the light of the literature.

MATERIALS AND METHODS

In our study, 55 cases of phyllodes tumor diagnosed between 2005-2018 in the Department of Medical Pathology were retrospectively studied. A total of 55 cases were included in the study.

RESULTS

All cases were female with a mean age of 39.7+15.2 years. Fifty-seven tumors diagnosed in 55 cases were classed as benign in 20 cases (35.1%), borderline in 14 cases (24.6%) and malignant phyllodes tumors in 23 cases (40.3%). Ductal carcinoma in situ (solid and cribriform type) were detected in one case with malignant phyllodes tumor, whereas invasive ductal carcinoma was detected in one case. Bilateral ductal carcinoma in situ was present in the patient with invasive ductal carcinoma.

CONCLUSION

These tumors which rapidly grow into large masses can be clinically and pathologically confused with benign lesions, macroscopic and microscopic evaluation of concomitant in situ-invasive carcinomas should be considered. Phyllodes tumors have an important role in breast surgery and pathology.

Observation of an Anisotropic Wigner Crystal

We report a new correlated phase of two-dimensional charged carriers in high magnetic fields, manifested by an anisotropic insulating behavior at low temperatures. It appears in a large range of low Landau level fillings 1/3≲ν≲2/3 in hole systems confined to wide GaAs quantum wells when the sample is tilted in magnetic field to an intermediate angle. The parallel field component (B_{∥}) leads to a crossing of the lowest two Landau levels, and an elongated hole wave function in the direction of B_{∥}. Under these conditions, the in-plane resistance exhibits an insulating behavior, with the resistance along B_{∥} about 10 times smaller than the resistance perpendicular to B_{∥}. We interpret this anisotropic insulating phase as a two-component, striped Wigner crystal.

Fractional quantum Hall effect and Wigner crystal of interacting composite fermions

In two-dimensional electron systems confined to GaAs quantum wells, as a function of either tilting the sample in a magnetic field or increasing density, we observe multiple spin-polarization transitions of the fractional quantum Hall states at filling factors ν=4/5 and 5/7. The number of observed transitions provides evidence that these are fractional quantum Hall states of interacting two-flux composite fermions. Moreover, the fact that the reentrant integer quantum Hall effect near ν=4/5 always develops following the transition to full spin polarization of the ν=4/5 fractional quantum Hall state links the reentrant phase to a pinned ferromagnetic Wigner crystal of composite fermions.

Fractional quantum Hall effect at ν=1/2 in hole systems confined to GaAs quantum wells

We observe the fractional quantum Hall effect (FQHE) at the even-denominator Landau level filling factor ν=1/2 in two-dimensional hole systems confined to GaAs quantum wells of width 30 to 50 nm and having bilayerlike charge distributions. The ν=1/2 FQHE is stable when the charge distribution is symmetric and only in a range of intermediate densities, qualitatively similar to what is seen in two-dimensional electron systems confined to approximately twice wider GaAs quantum wells. Despite the complexity of the hole Landau level structure, originating from the coexistence and mixing of the heavy- and light-hole states, we find the hole ν=1/2 FQHE to be consistent with a two-component, Halperin-Laughlin (Ψ331) state.