15 YEARS OF PARAGANGLIOMA: Pathology of pheochromocytoma and paraganglioma

    1. Ronald R deKrijger1,2
    1. Department of Pathology and Laboratory Medicine, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 802, Boston, Massachusetts 02111, USA
      1Department of Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
      2Department of Pathology, Reinier de Graaf Hospital, Delft, The Netherlands
    1. Correspondence should be addressed to A S Tischler; Email: atischler{at}tuftsmedicalcenter.org

    Abstract

    Pathologists using their routine diagnostic tools can contribute both to the care of patients with pheochromocytoma/paraganglioma and to understanding the pathobiology of the tumors. They can document details of tissue organization and cytology that are accessible only by microscopy and can characterize admixtures of cell types that are morphologically distinct or show differential expression of immunohistochemical markers. Current roles and challenges for pathologists include differential diagnosis, identifying clues to the presence of hereditary disease, and effective communication of pathology information for clinical and research purposes. Future roles will increasingly involve risk stratification, identification of actionable targets for personalized therapies, and aiding the interpretation of molecular tests by helping characterize genetic variants of unknown significance. It remains to be determined to what extent the need for pathology input will be overshadowed by the availability of genetic testing and other molecular analyses at ever-decreasing cost, together with very effective clinical paradigms for risk stratification and patient care.

    Keywords
    • Revision received 26 June 2015
    • Accepted 1 July 2015
    • Made available online as an Accepted Preprint 1 July 2015
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