WHO Classification for Grading Pancreatic Endocrine Neoplasms

The World Health Organization (WHO) graded pancreatic endocrine neoplasms based on histologic features.

Parameters:

(1) extent

(2) angioinvasion or perineural invasion

(3) diameter in cm

(4) mitotic rate in 10 high power fields (40x objective lens)

(5) percent cells Ki-67 positive

Parameter	Benign Behavior	Uncertain Behavior	Malignant Behavior
extent	confined to pancreas	confined to pancreas	gross local invasion or metastases
angioinvasion or perineural invasion	neither	either
diameter in cm	< 2 cm	>= 2 cm
mitotic rate	< 2 in 10 hpf	2 - 10
percent Ki-67	< 2%	>= 2%

where:

• Benign behavior = well-differentiated = low grade

• I am not sure how > 10 mitoses per 10 hpf is graded but this would probably be malignant.

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