How do you determine if a carcinoid tumor is typical or atypical?

Eugene Woltering, MD, FACS,  answers: ” Well, the procedure that I use is to:
1. Look at the path report and look for key words like mitotic indices necrosis and the key word differentiation.
2. Get a Ki -67 and clearly, the lower this number the better.  Numbers over 20% ( some say 10%) are atypical indicators.
3. Get stain on the tumor for CGA and synaptophysin and ask the path guy/gal to actually count the percentage of cells that are positive/negative.”

Dr. Woltering is The James D. Rives Professor of Surgery and Neurosciences, Chief of Sections of Surgical Oncology and Endocrinology, and Director of Surgical Research, LSUHSC Neuroendocrine – Carcinoid Tumors at Ochsner Medical Center — Kenner in Louisiana. The Neuroendocrine Tumor Program at Ochsner Medical
Center – Kenner specializes in the diagnosis and management of all forms of neuroendocrine tumors
of the gastroenteropancreatic axis. In partnership with Louisiana State University Health
Sciences Center, the Neuroendocrine Tumor Program offers multidisciplinary clinical care for the neuroendocrine patient: medical, surgical and nutritional.

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