# The 2019 WHO classification of tumours of the digestive system

Source: https://onco.cc/key-papers/paper-who-2019-digestive-system-tumours-nagtegaal-histopathology-2020/  
OnCo record `paper-who-2019-digestive-system-tumours-nagtegaal-histopathology-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The current WHO rulebook for cancers of the gut, which among other changes renamed goblet cell carcinoid as goblet cell adenocarcinoma, adopted the LAMN terminology for appendiceal tumours and re-graded neuroendocrine neoplasms.

## Summary

Overview by the WHO Classification of Tumours Editorial Board of the fifth-edition digestive system volume, summarising changes across oesophagus, stomach, small bowel, appendix, colorectum, liver, biliary tract and pancreas.

For the appendix it adopts low-grade and high-grade appendiceal mucinous neoplasm and reclassifies goblet cell carcinoid as goblet cell adenocarcinoma with a three-tier grade; it also separates neuroendocrine tumours from neuroendocrine carcinomas and introduces molecular subtypes across sites.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: Histopathology
- Year: 2020
- DOI: 10.1111/his.13975
- Authors: Nagtegaal ID, Odze RD, Klimstra D, et al.
- What it means: The names on an appendix or small bowel pathology report, and hence which OnCo subtype page applies, follow this classification.
- Caveats: The summary paper describes the changes; the full volume holds the diagnostic criteria.; Some renamings (goblet cell adenocarcinoma) are still working through registries and older literature.

## Sources

- Histopathology 2020: https://doi.org/10.1111/his.13975
- PubMed: https://pubmed.ncbi.nlm.nih.gov/31433515/

## Connected records

- cancers: [Appendiceal adenocarcinoma (mucinous and non-mucinous, including signet ring cell)](https://onco.cc/cancers/appendiceal-adenocarcinoma/), [Goblet cell adenocarcinoma of the appendix](https://onco.cc/cancers/goblet-cell-adenocarcinoma/), [Localised small bowel adenocarcinoma (stage I to III, resected)](https://onco.cc/cancers/localised-small-bowel-adenocarcinoma/), [Low-grade appendiceal mucinous neoplasm and pseudomyxoma peritonei](https://onco.cc/cancers/low-grade-appendiceal-mucinous-neoplasm/)

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