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World J Clin Cases. Sep 6, 2019; 7(17): 2413-2419
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2413
Multifocal G1-G2 gastric neuroendocrine tumors: Differentiating between Type I, II and III, a clinicopathologic review
Khaled Algashaamy, Monica Garcia-Buitrago
Khaled Algashaamy, Monica Garcia-Buitrago, Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Miami, FL 33136, United States
Author contributions: Algashaamy K and Garcia-Buitrago M wrote this review.
Conflict-of-interest statement: The authors have nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Khaled Algashaamy, MBBS, MD, Doctor, Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Holtz Center, 1611 NW 12th Avenue, Suite 2044, Miami, FL 33136, United States. khaled.algashaamy@jhsmiami.org
Received: April 23, 2019
Peer-review started: May 8, 2019
First decision: May 31, 2019
Revised: July 26, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 6, 2019
Processing time: 137 Days and 9.6 Hours
Abstract

Gastric neuroendocrine tumors (gNETs) are a rare entity that is increasing in incidence. Different pathophysiological processes can lead to the development of these tumors, appropriate histological analysis is necessary to differentiate between grade 1 (G1) and grade 2 (G2) tumors as this will impact the management of these patients based on their increased risk of lymph node and distant metastases. To provide a comprehensive clinicopathologic review of multifocal gastric neuroendocrine tumors, with particular emphasis on G1 and G2 tumors and differentiating between types I, II and II and risk stratification based upon immunohistochemical profile. This review is based on peer-reviewed literature and the authors’ experience. gNETs are a heterogenous group of tumors that is rising in incidence. These lesions while arise from the same cell type, they have different etiologies. Identifying the type of gNETs is a collective effort of clinical and pathologic correlation. The correct grading and staging of these lesions are of paramount significance, due its impact on patient management and prognosis.

Keywords: Gastric neuroendocrine tumors; Enterochromaffin like cells; Histopathological features; Immunohistochemistry; Diagnosis; Treatment

Core tip: Gastric neuroendocrine tumors are a rare entity with increasing incidence. Different pathophysiological processes can lead to the development of these tumors, appropriate histological analysis is necessary to differentiate between grade 1 (G1) and grade 2 (G2) tumors as this will impact the management of these patients based on their increased risk of lymph node and distant metastases. In this mini-review article, we aim to provide a comprehensive clinicopathologic review of multifocal gastric neuroendocrine tumors, with particular emphasis on G1 and G2 tumors and differentiating between types I, II and II and risk stratification based upon immunohistochemical profile. We have based this review on peer-reviewed literature and the authors’ experience.