Pulmonary carcinoid tumourlet: Difference between revisions

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'''Pulmonary carcinoid tumourlet''', also '''carcinoid tumourlet''', is a small benign proliferation of Kulchitsky cells.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Lung carcinoid tumourlet - low mag.jpg
| Width      =
| Caption    = Lung carcinoid tumourlet. [[H&E stain]].
| Synonyms  = carcinoid tumourlet
| Micro      = cells with salt and pepper chromatin, usually nested architecture, no necrosis, minimal mitotic activity (see below), must be through the bronchial basement membrane
| Subtypes  =
| LMDDx      = [[pulmonary neuroendocrine cell hyperplasia]], [[typical carcinoid lung tumour]], [[atypical lung carcinoid tumour]], [[pulmonary meningothelial-like nodule]]
| Stains    =
| IHC        = Ki-67 ~2% (0-7%)
| EM        =
| Molecular  =
| IF        =
| Gross      = <5 mm by definition
| Grossing  =
| Site      = [[lung]] - see ''[[lung tumours]]''
| Assdx      =
| Syndromes  = [[Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia]]
| Clinicalhx = often an incidental finding
| Signs      =
| Symptoms  =
| Prevalence = not common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Pulmonary carcinoid tumourlet''', also '''carcinoid tumourlet''', is a small benign proliferation of Kulchitsky cells. 
 
The entity is separated from the ''[[typical lung carcinoid tumour]]'' by size. Carcinoid tumourlets are < 5 mm, typical lung carcinoid tumours are >=5 mm.  


==General==
==General==
*Neuroendocrine cell proliferation.<ref name=pmid8109497>{{Cite journal  | last1 = Bennett | first1 = GL. | last2 = Chew | first2 = FS. | title = Pulmonary carcinoid tumorlets. | journal = AJR Am J Roentgenol | volume = 162 | issue = 3 | pages = 568 | month = Mar | year = 1994 | doi =  | PMID = 8109497 | URL = http://www.ajronline.org/content/162/3/568.full.pdf }}</ref>
*Neuroendocrine cell proliferation.<ref name=pmid8109497>{{Cite journal  | last1 = Bennett | first1 = GL. | last2 = Chew | first2 = FS. | title = Pulmonary carcinoid tumorlets. | journal = AJR Am J Roentgenol | volume = 162 | issue = 3 | pages = 568 | month = Mar | year = 1994 | doi =  | PMID = 8109497 | URL = http://www.ajronline.org/content/162/3/568.full.pdf }}</ref>
**Essentially a small [[typical carcinoid lung tumour|typical carcinoid]].
**Essentially a small [[typical carcinoid lung tumour|typical carcinoid]].
*Arise from Kulchitsky cells of the bronchial epithelium.<ref name=pmid9064089>{{Cite journal  | last1 = Ramón Capilla | first1 = M. | last2 = Arnau Obrer | first2 = A. | last3 = Navarro Ibáñez | first3 = R. | last4 = Galbis Caravajal | first4 = J. | last5 = Traves Zapata | first5 = V. | last6 = Cantó Armengod | first6 = A. | title = [Pulmonary tumorlet. Report of 5 cases]. | journal = Arch Bronconeumol | volume = 32 | issue = 9 | pages = 489-91 | month = Nov | year = 1996 | doi =  | PMID = 9064089 }}</ref>
*Arise from ''Kulchitsky cells'' of the bronchial epithelium.<ref name=pmid9064089>{{Cite journal  | last1 = Ramón Capilla | first1 = M. | last2 = Arnau Obrer | first2 = A. | last3 = Navarro Ibáñez | first3 = R. | last4 = Galbis Caravajal | first4 = J. | last5 = Traves Zapata | first5 = V. | last6 = Cantó Armengod | first6 = A. | title = [Pulmonary tumorlet. Report of 5 cases]. | journal = Arch Bronconeumol | volume = 32 | issue = 9 | pages = 489-91 | month = Nov | year = 1996 | doi =  | PMID = 9064089 }}</ref>
*May be seen in the context of [[diffuse idiopathic pulmonary neuroendocrine cell hyperplasia]].


==Microscopic==
==Microscopic==
Features:
Features:
*Nests of cells - classic pattern.
*Neuroendocrine cells - usually in nests (classic pattern).
**Salt and pepper chromatin - '''key feature'''.
**Salt and pepper chromatin - '''key feature'''.
*Nuclei round or ellipsoid.
*Size criterion: <5 mm.<ref name=pct_ucsf>URL: [http://pathhsw5m54.ucsf.edu/case7/image75.html http://pathhsw5m54.ucsf.edu/case7/image75.html]. Accessed on: 23 January 2012.</ref><ref name=pmid23205296>{{Cite journal  | last1 = He | first1 = P. | last2 = Gu | first2 = X. | last3 = Wu | first3 = Q. | last4 = Lin | first4 = Y. | last5 = Gu | first5 = Y. | last6 = He | first6 = J. | title = Pulmonary carcinoid tumorlet without underlying lung disease: analysis of its relationship to fibrosis. | journal = J Thorac Dis | volume = 4 | issue = 6 | pages = 655-8 | month = Dec | year = 2012 | doi = 10.3978/j.issn.2072-1439.2012.06.11 | PMID = 23205296 }}</ref>
*Size criterion: <5 mm.<ref name=pct_ucsf>URL: [http://pathhsw5m54.ucsf.edu/case7/image75.html http://pathhsw5m54.ucsf.edu/case7/image75.html]. Accessed on: 23 January 2012.</ref><ref name=pmid23205296>{{Cite journal  | last1 = He | first1 = P. | last2 = Gu | first2 = X. | last3 = Wu | first3 = Q. | last4 = Lin | first4 = Y. | last5 = Gu | first5 = Y. | last6 = He | first6 = J. | title = Pulmonary carcinoid tumorlet without underlying lung disease: analysis of its relationship to fibrosis. | journal = J Thorac Dis | volume = 4 | issue = 6 | pages = 655-8 | month = Dec | year = 2012 | doi = 10.3978/j.issn.2072-1439.2012.06.11 | PMID = 23205296 }}</ref>
*Must be through the bronchial basement membrane.<ref name=pmid20729444>{{Cite journal  | last1 = Koo | first1 = CW. | last2 = Baliff | first2 = JP. | last3 = Torigian | first3 = DA. | last4 = Litzky | first4 = LA. | last5 = Gefter | first5 = WB. | last6 = Akers | first6 = SR. | title = Spectrum of pulmonary neuroendocrine cell proliferation: diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, tumorlet, and carcinoids. | journal = AJR Am J Roentgenol | volume = 195 | issue = 3 | pages = 661-8 | month = Sep | year = 2010 | doi = 10.2214/AJR.09.3811 | PMID = 20729444 }}</ref>


DDx:  
DDx:  
*[[Typical carcinoid lung tumour]].
*[[Pulmonary neuroendocrine cell hyperplasia]] - proliferation confined by bronchial basement membrane.<ref name=pmid20729444>{{Cite journal  | last1 = Koo | first1 = CW. | last2 = Baliff | first2 = JP. | last3 = Torigian | first3 = DA. | last4 = Litzky | first4 = LA. | last5 = Gefter | first5 = WB. | last6 = Akers | first6 = SR. | title = Spectrum of pulmonary neuroendocrine cell proliferation: diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, tumorlet, and carcinoids. | journal = AJR Am J Roentgenol | volume = 195 | issue = 3 | pages = 661-8 | month = Sep | year = 2010 | doi = 10.2214/AJR.09.3811 | PMID = 20729444 }}</ref>
*[[Typical carcinoid lung tumour]] - must be >= 5 mm.
*[[Pulmonary meningothelial-like nodule]] - whorled appearance, ''not'' associated with an airway.


===Images===
===Images===
<gallery>
Image: Lung carcinoid tumourlet - very low mag.jpg | CT - very low mag. (WC)
Image: Lung carcinoid tumourlet - low mag.jpg | CT - low mag. (WC)
Image: Lung carcinoid tumourlet - intermed mag.jpg | CT - intermed. mag. (WC)
Image: Lung carcinoid tumourlet - high mag.jpg | CT - high mag. (WC)
Image: Lung carcinoid tumourlet - alt - high mag.jpg | CT - high mag. (WC)
Image: Lung carcinoid tumourlet - very high mag.jpg | CT - very high mag. (WC)
Image: Lung carcinoid tumourlet - alt - very high mag.jpg | CT - very high mag. (WC)
</gallery>
www:
*[http://pathhsw5m54.ucsf.edu/case7/image75.html Tumourlets - several images (ucsf.edu)].
*[http://pathhsw5m54.ucsf.edu/case7/image75.html Tumourlets - several images (ucsf.edu)].


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==See also==
==See also==
*[[Lung_tumours]].
*[[Lung tumours]].
*[[Neuroendocrine neoplasms]].


==References==
==References==
Retrieved from "https://librepathology.org/wiki/Pulmonary_carcinoid_tumourlet"