Diagnostic role of endoscopic ultrasonography in defining the clinical features and histopathological spectrum of gastroenteropancreatic neuroendocrine tumors

Table 1 Demographics, clinical features, and tumor characteristics of patients

Variable	Frequency (No.)	Percentage (%)
Total	14	100.00
Age, mean ± SD	52.0 ± 14.0 (range 34-74)
Gender
Male	10	71.40
Female	4	28.60
Clinical presentations
Abdominal pain	11	78.60
Weight loss	12	85.70
Jaundice	2	14.30
Generalized weakness	1	7.10
Dyspepsia	1	7.10
Size of lesion, mean ± SD	4.5 ± 2.4 (range 0.4-9.8)
Duration from symptom onset to disease diagnosis, weeks	4 (range 2-8)
Metastatic type of tumor
Yes	8	57.10
No	6	42.90

Table 2 Diagnostic modalities including computed tomography scan and endoscopic ultrasonography details

Variable	Frequency (No.)	Percentage (%)
Total	14	100.0
CT scan status
Yes	13	92.9
No	1	7.1
CT scan successfully identifies lesion
Yes	13	100.0
EGD
Yes	1	7.1
No	13	92.9
Indication for EUS based on CT and EGD findings
Pancreatic mass	6	42.9
Pancreatic cyst	1	7.1
Pancreatic tail lesion and ductal dilation	1	7.1
Porta hepatis mass	2	14.3
Paraduodenal lesion	1	7.1
Liver lesion	1	7.1
Mediastinal lymphadenopathy	1	7.1
Extrinsic mass compressing pyloric area	1	7.1
EUS diagnosis
EUS guided FNB	14	100.0
Complications	0	0.0
EUS procedure’s setting
Endoscopy suite	13	92.9
In-patient	1	7.1

CT: Computed tomography; EGD: Esophagogastroduodenoscopy; EUS: Endoscopic ultrasonography; FNB: Fine needle biopsy.

Table 3 Histopathological and immunohistochemical analysis

Variable	Frequency (No.)	Percentage (%)
Total	14	100.0
Histopathology types
Well differentiated tumor	11	78.6
Grade 1	4	28.6
Grade 2	6	42.9
Grade 3	1	7.1
Poorly differentiated tumor	3	21.4
Small cell	2	14.3
Large cell	1	7.1
Cytokeratin AE1/AE3
Positive	13	92.9
Ki-67
Positive	14	100.0
G1 (≤ 2%)	3	21.4
G2 (3%-20%)	8	57.2
G3 (> 20%)	3	21.4
Synaptophysin
Positive	14	100.0
Chromogranin A
Positive	5	35.7
Negative	1	7.1
Not done	8	57.2

Table 4 Management plan and survival status of patients

Variable	Frequency (No.)	Percentage (%)
Total	14	100.0
Surgical procedure
Yes	4	28.6
No	10	71.4
Surgical procedure type
Whipple procedure	1	7.1
Paraganglioma excision with right adrenalectomy	1	7.1
Excision of deep cervical lymph node	1	7.1
Laparotomy and radical excision of paraduodenal neuroendocrine tumor	1	7.1
Additional management type
Chemotherapy	2	14.3
Palliative care	1	7.1
Vital status
Alive	14	100.0