Sandbox:Hannan1

Neuroendocrine tumor		Clinical manifestations		Dianosis						Gold standard	Other features
		Symptoms	Signs	Blood & Urine	Gross	Histology	Immunohistochemistry	Imaging	Others
Medullary thyroid carcinoma		Dysphagia Hoarseness Respiratory difficulty Flushing Diarrhea Weight loss	Palpable neck mass Signs of Cushing syndrome	↑ Calcitonin ↑ Serum calcium ↑ or - Cortisol ↑ CEA level	White or gray in color Firm to palpation	Nests of uniform cells Deposition of stromal amyloid Granular chromatin C-cell hyperplasia	Calcitonin Chromogranin A Carcinoembryonic antigen (CEA)	Solid thyroid nodule (US) CT scan/MRI and PET scan for metastatis	Genetic testing	FNA cytology with immunohisto- chemistry and calcitonin levels	Associated with MEN 2A and 2B Familial association with RET mutations May present as Cushing syndrome
Pheochromocytoma		Headaches Palpitations Excessive sweating Anxiety Pallor Pain in chest/abdomen Weakness, fatigue Nausea/vomiting Dizziness Paresthesias Constipation (rarely diarrhea) Visual disturbance	Hypertension Postural hypotension Tachycardia or reflex bradycardia Tremulousness Pallor Flushing (rare) Weight loss Fasting hyperglycaemia Decreased GI motility Pallor ↑ Respiratory rate Psychosis	↑ Plasma and urine catecholamines ↑ Plasma and urine metanephrines ↑ Chromogranin A ↑ Plasma methoxytyramine	N/A	Loosely cohesive clusters Scattered tumor cells with prominent anisokaryosis, abundant eosinophilic granular cytoplasm and indistinct cell borders Occasional binucleate cells	Chromogranin A (CGA) Protein gene product (PGP) 9.5 Synaptophysin (SYN) CD56 (also known as neural cell adhesion molecule or N-CAM) Glial fibrillary acidic protein (GFAP)	Heterogeneous appearance, often with some cystic areas. Calcifications or hemorrhage may also be present (CT) T2-bright lesions, with/without cystic or necrotic components (MRI) Cystic or solid with necrotic areas or hemorrhages (U/S)	Genetic testing Provacative glucagon test Clonidine suppression test Metaiodobenzyl-guanidine scintigraphy PET scan Octereoscan
Merkel cell carcinoma
Parathyroid adenoma
Paraganglioma
Pituitary gland tumors
Neuroendocrine tumors of the ovaries or testicles
Thymic neuroendocrine cancer
Lung neuroendocrine tumors	Typical carcinoid tumours
	Atypical carcinoid tumours
	Large cell lung neuroendocrine carcinomas
	Small cell lung neuroendocrine carcinomas
Pancreatic neuroendocrine tumours	Gastrinoma
	Insulinoma
	Glucagonoma
	Somatostatinoma
	VIPoma
	ACTHoma
Gastric neuroendocrine tumors	Type I GNET
	Type II GNET
	Type III GNET
	Type IV GNET
Duodenal neuroendocrine tumors	Gastrinomas
	Somatostatinomas
	Gangliocytic paraganglionomas
	Nonfunctioning NET
	neuroendocrine carcinomas
Jejuno-Ileal neuroendocrine tumors
Appendix neuroendocrine tumors
Colon neuroendocrine tumors
Rectum neuroendocrine tumors