Morphological and immunohistochemical characteristics associated with metastatic and recurrent progression in pheochromocytoma/paraganglioma: A cohort study

• Published in: Annals of diagnostic pathology Vol. 60; p. 151981
• Main Authors: Wang, Ling-Ling, Wei, Xue-Jing, Zhang, Qiao-Chu, Li, Feng
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2022
• Subjects: Metastasis; Paraganglioma; Pheochromocytoma; Recurrence; S-100; Succinate dehydrogenase; PPGL; Recurrence; Succinate dehydrogenase; Pheochromocytoma; Paraganglioma; Metastasis; S-100; PCC; PASS; PGL; SDH; GAPP; WHO
• ISSN: 1092-9134; 1532-8198
• DOI: 10.1016/j.anndiagpath.2022.151981

This study aimed to evaluate immunohistochemical markers of pheochromocytoma/paraganglioma (PPGL) and the relationships between the grading system for adrenal pheochromocytoma and paraganglioma (GAPP) and the prognosis of PPGL in a Chinese population. A retrospective analysis was conducted on a cohort of 102 PPGL cases, from January 2012 to December 2019, with complete clinicopathological and follow-up data. Surgical pathology slides were re-reviewed. All histological parameters involved in GAPP were summarized. The relationship between clinical characteristics, expression of SDHB (succinate dehydrogenase), S-100 and Ki-67 as well as GAPP classifications and prognosis of PPGL was statistically analyzed. The 102 cases included 51 males (50%) and 51 females (50%) with a median age of 48.7 years. The median tumor size was 6.8 cm. Metastases or relapse developed in 23 (22.5%) cases. Larger tumor size, extra-adrenal location, and poorly differentiated PPGL according to GAPP were associated with metastases or relapse (P < 0.05). Histological parameters, including the appearance of large or fused cell nests, necrosis, vascular invasion, and capsular invasion, were more common in the cases with metastases or relapse (P < 0.01). Loss of SDHB or S-100 expression was more common in poorly differentiated PPGL and associated with metastases or relapse (P < 0.01). However, no significant difference in the Ki-67 index between the clinically malignant and benign group was observed. GAPP is thus helpful for evaluations of the biological behavior of PPGL. •Loss expression of SDHB or S-100 was more common in poorly differentiated PPGL and associated with metastases or relapse.•Grading system for adrenal pheochromocytoma and paraganglioma (GAPP) is helpful for the evaluation of the biological behavior of PPGL.