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Erschienen in: Der Pathologe 3/2015

01.05.2015 | Schwerpunkt: Neuroendokrine Tumoren

Neues aus der Tumorpathologie der Nebenniere

verfasst von: Prof. Dr. W. Saeger

Erschienen in: Die Pathologie | Ausgabe 3/2015

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Zusammenfassung

Drei Tumorentitäten prägen die Routinepathologie der Nebenniere: die Rindentumoren, die Marktumoren und die Metastasen. Die Abgrenzung dieser 3 voneinander ist strukturell oft schwierig, mithilfe immunhistologischer Untersuchungen aber fast immer eindeutig möglich: die Rindentumoren sind positiv für den steroidogenen Faktor 1 (SF-1) und Melan A und immer negativ für Chromogranin A, die Marktumoren exprimieren immer Chromogranin A und sind zwingend negativ für Keratin. Für die Abgrenzung der Metastasen, aber auch der seltenen epitheloiden Angiosarkome steht ein breites Spektrum von Antikörpern zur Verfügung. Bei den Rindentumoren sind die Adenome von den Karzinomen durch Einsatz dreier Scoringsysteme zu unterscheiden, und der Ki-67-Index sollte bei Adenomen nicht über 3 % liegen. Damit gelingt die Dignitätsbestimmung in etwa 90 % der Fälle. Gut- und bösartige Phäochromozytome sind durch 2 Scoringsysteme meistens nicht sicher, aber oft näherungsweise zu differenzieren.
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Metadaten
Titel
Neues aus der Tumorpathologie der Nebenniere
verfasst von
Prof. Dr. W. Saeger
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Pathologie / Ausgabe 3/2015
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI
https://doi.org/10.1007/s00292-015-0020-4

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