ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 Methods: All NIFTP cases registered in Targu-Mureş Pathology Department between 2016-2021 were reviewed. The incidence of NIFTP was calculated in relation to the number of papillary thyroid carcinomas (PTCs) registered over the study period. Then, the inci- dence of NIFTP between 2016-2018 was compared to the incidence between 2019-2021, 2018 marking the year when the diagnostic criteria of NIFTP were revised. Results: A total number of 43 cases of NIFTPs were diagnosed in our department between 2016-2021, with an overall NIFTP incidence of 13.5% [CI 10.06-18.11], among the 319 PTCs cases registered over the same period. When the incidence of NIFTP was compared between the two periods (2016-2018 versus 2019-2021), we found out that the overall incidence of NIFTP has dropped from 15.13% [CI 10.0-22.83] to 11.97% [ CI 7.77 -18.42] in the second evaluated period. Conclusion: In this study, we documented a low NIFTP incidence in our institution over the last 5 years. The fact that NIFTP inci- dence decreased after refining the diagnostic criteria in 2018, emphasize the need to apply very stringent histomorphologic cri- teria when making a diagnosis of NIFTP, in order to avoid over- treatment of a tumour with indolent behaviour. PS-14-007 A 20- year retrospective analysis of adrenal tumour pathology in Mure ș County, Romania. What has changed? R. Catana*, E.A. Szasz, A. Nechifor- Boila, A. Borda *George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania Background & objectives: Primary adrenal malignancies are rare tumours. The aim of the study was to examine time-trends of tumour adrenal pathology and to analyse the distribution of their different his- tology in a 20-year retrospective study (2000-2019), in Mure ș County, Romania. Methods: Patients clinic-pathological features were obtained from database registries of Department of Pathology, County Emergency Clinical Hospital, Târgu-Mure ș . Histological types of adrenal tumours were classified according to WHO 2017 crite- ria. Due to a small number of cases, in order to establish a trend for incidence, we analysed the cases distribution in 4 periods of 5 years:2000-2004, 2005-2009, 2010-2014 and, respectively, 2015-2019. Results: We first identified 101 patients who underwent an adrenal surgery between 2000-2019. Subsequently, the analysis included only cases classified as tumours of the adrenal cortex (62,72.9%) or adrenal medulla (23,27.1%). The most common adrenal tumours were adenomas 35%, followed by pheochromocytomas 24%, car- cinomas 15%, metastatic tumours 14%, myelolipomas 7%, neuro- blastic tumours 4%, lymphomas 1%. The average age at the time of diagnosis was 54.13 year-old for adenomas, 49.73 for carcinomas and 47.85 for pheochromocyto- mas. The average size of the carcinomas was 88.2 mm, and 60.4 mm for pheochromocytomas. An increased number of adrenal adenomas (56,26%) was noticed in the last period 2015-2019, increasing the total number of adrenal tumours (37.64%). Conclusion: Although not very common, adrenal tumours express a varied pathology with special features that must always be in the pathologist’s attention for a diagnosis as accurate as possible. The recent increase in adrenal tumours cases, due to benign and prob- ably non-secretory tumours, could be attributed to the frequent use of imaging methods. The incidence of adrenal cancer did not have an upward trend. PS-14-008 Evaluating proliferation in medullary thyroid carcinoma M.A. Bani*, M. Faron, C. Kanaan, P. Khneisser, L. Lacroix, L. Lamartina, J. Hadoux, D. Hartl, X. Sastre-Garau, E. Baudin, J. Scoazec, A. Al Ghuzlan *Department of Medical Biology and Pathology, Morphological pathology laboratory, Gustave Roussy Cancer Campus, Villejuif, France / Paris-Saclay university, Gustave Roussy Cancer Centre, Inserm US23, CNRS UMS3655, AMMICa, Villejuif, France Background & objectives: Medullary thyroid carcinoma (MTC) is a rare malignant neuroendocrine neoplasia. Recent studies demonstrated that proliferation is one of the most important prognostic factors. Various methods are available for the measurement of proliferation, including mitotic counts and immunohistochemistry of proliferation- associated antigens. Methods: A total of 100 initial thyroidectomy specimens were examined microscopically. The mitotic index (MI), Ki67, PHH3 and MCM6 proliferative indexes were evaluated. Measurements were obtained in the area showing the highest proliferative activity. MI and PHH3 were assessed per 2mm2. For the Ki67 and MCM6 proliferative indexes, 500 to 2000 tumour cells were counted per tumour. Results: All of the four proliferative indicators were signifi- cant predictors of overall survival (OS), biological (B-DFS) and morphological disease free survival (M-DFS). MI was associated with a decrease in OS (hazard ratio [HR]=1.26, 95% confidence interval [CI]=1.18-1.35, p<0.001), M-DFS (HR=1.2, CI=1.13-1.27, p<0.001) and B-DFS (HR=1.13, CI=1.08-1.19, p<0.001). PHH3 was associated with a decrease in OS (HR=1.15, CI=1.05-1.28, p=0.022), M-DFS (HR=1.09, CI=1.02-1.16, p=0.036) and B-DFS (HR=1.10, CI=1.05- 1.16, p=0.001). MCM6 was also associated with a decrease in OS (HR=1.06, CI=1.03-1.08, p<0.001), M-DFS (HR=1.03, CI=1.00-1.05, p=0.049) and B-DFS (HR=1.04, CI=1.02-1.06, p<0.001). Conclusion: We demonstrateded that all proliferation measure- ment methods are significant prognostic predictors. These indi- cators are continuous variables, and as each variable increases, prognosis worsens. We recommend reporting at least one of these proliferation indexes in addition to conventional prognostic factors for MTC. PS-14-009 Neuroendocrine metastasis in the digestive system A. Fitouri*, M.A. Bani, P. Dartigues, C. Kanaan, G. Tomassic, J. Scoazec *Pathology Department, Salah Azaiez Institute, Tunis, Tunisia; Research Laboratory LR21SP01, Tunis, Tunisia Background & objectives: Metastasis of neuroendocrine carcinomas (NEC) in the digestive system are possible and present an unusual mode of revelation. They represent a real challenge for the pathologist since they mimic primary neuroendocrine pancreato-gastrointestinal tumours. Methods: A review of all neuroendocrine metastasis in the gastro- intestinal tract and pancreas of the Gustave Roussy Campus Cancer pathology department was performed between 2015 and 2021. Results: Three cases of secondary NEC in gastro-intestinal tract and pancreas were found. They were all men aged 58, 68 and 73 years old. Two had pancreatic tumours and one had a small intestine tumour. Diagnosis was made on the second opin- ion expert consultation. The two pancreatic tumours showed S139