Difference between revisions of "Atypical lung carcinoid tumour"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Atypical lung carcinoid -- intermed mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Atypical lung carcinoid tumour. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = atypical carcinoid, atypical lung carcinoid, atypical pulmonary carcinoid | ||
| Micro = | | Micro = | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = [[small cell carcinoma of the lung]], [[carcinoid lung tumour]], [[pulmonary carcinoid tumourlet]], [[lung adenocarcinoma]], metastatic [[small cell carcinoma]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = Ki-67 ~17% (range 10-26%) | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 26: | Line 26: | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = moderate; poor vis-à-vis typical carcinoid | ||
| Other = | | Other = | ||
| ClinDDx = other [[lung tumours]] | | ClinDDx = other [[lung tumours]] | ||
| Tx = | | Tx = surgical resection +/-chemotherapy | ||
}} | }} | ||
'''Atypical carcinoid lung tumour''', also '''atypical carcinoid''', is an uncommon [[lung tumours|lung tumour]] with a poor outcome. | '''Atypical carcinoid lung tumour''', also '''atypical carcinoid''', is an uncommon [[lung tumours|lung tumour]] with a poor outcome. | ||
| Line 35: | Line 35: | ||
==General== | ==General== | ||
*Approximately 20% of [[lung carcinoid]]s.<ref name=pmid20888248>{{Cite journal | last1 = Naalsund | first1 = A. | last2 = Rostad | first2 = H. | last3 = Strøm | first3 = EH. | last4 = Lund | first4 = MB. | last5 = Strand | first5 = TE. | title = Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. | journal = Eur J Cardiothorac Surg | volume = 39 | issue = 4 | pages = 565-9 | month = Apr | year = 2011 | doi = 10.1016/j.ejcts.2010.08.036 | PMID = 20888248 }}</ref> | *Approximately 20% of [[lung carcinoid]]s.<ref name=pmid20888248>{{Cite journal | last1 = Naalsund | first1 = A. | last2 = Rostad | first2 = H. | last3 = Strøm | first3 = EH. | last4 = Lund | first4 = MB. | last5 = Strand | first5 = TE. | title = Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study. | journal = Eur J Cardiothorac Surg | volume = 39 | issue = 4 | pages = 565-9 | month = Apr | year = 2011 | doi = 10.1016/j.ejcts.2010.08.036 | PMID = 20888248 }}</ref> | ||
Prognosis: | |||
*Significantly worse than for typical carcinoids; in one series,<ref name=pmid26195112>{{Cite journal | last1 = Ayadi-Kaddour | first1 = A. | last2 = Marghli | first2 = A. | last3 = Zairi | first3 = S. | last4 = Zribi | first4 = H. | last5 = Ismail | first5 = O. | last6 = Braham | first6 = E. | last7 = Hantous-Zannad | first7 = S. | last8 = Kilani | first8 = T. | last9 = El Mezni | first9 = F. | title = [Bronchopulmonary carcinoid tumors: Tunisian experience with 115 surgically treated cases]. | journal = Rev Pneumol Clin | volume = 71 | issue = 6 | pages = 319-26 | month = Dec | year = 2015 | doi = 10.1016/j.pneumo.2015.04.003 | PMID = 26195112 }}</ref> the five year survival was 95% and 45% for typical carcinoid and atypical carcinoid respectively. | |||
Treatment: | |||
*Surgery for diagnosis and treatment. | |||
*Chemotherapy for advanced/metastatic disease.<ref name=pmid25218177>{{Cite journal | last1 = Chong | first1 = CR. | last2 = Wirth | first2 = LJ. | last3 = Nishino | first3 = M. | last4 = Chen | first4 = AB. | last5 = Sholl | first5 = LM. | last6 = Kulke | first6 = MH. | last7 = McNamee | first7 = CJ. | last8 = Jänne | first8 = PA. | last9 = Johnson | first9 = BE. | title = Chemotherapy for locally advanced and metastatic pulmonary carcinoid tumors. | journal = Lung Cancer | volume = 86 | issue = 2 | pages = 241-6 | month = Nov | year = 2014 | doi = 10.1016/j.lungcan.2014.08.012 | PMID = 25218177 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
| Line 47: | Line 54: | ||
*[[Typical carcinoid lung tumour]]. | *[[Typical carcinoid lung tumour]]. | ||
*[[Small cell carcinoma of the lung]]. | *[[Small cell carcinoma of the lung]]. | ||
*Metastatic [[small cell carcinoma]]. | |||
*[[Lung adenocarcinoma]]. | |||
===Images=== | |||
<gallery> | |||
Image: Atypical lung carcinoid -- low mag.jpg | ALC - low mag. | |||
Image: Atypical lung carcinoid -- intermed mag.jpg | ALC - intermed. mag. | |||
Image: Atypical lung carcinoid -- high mag.jpg | ALC - high mag. | |||
Image: Atypical lung carcinoid -- very high mag.jpg | ALC - very high mag. | |||
Image: Atypical lung carcinoid - alt -- high mag.jpg | ALC - high mag. | |||
Image: Atypical lung carcinoid - alt -- very high mag.jpg | ALC - very high mag. | |||
Image: Atypical lung carcinoid - alt -- extremely high mag.jpg | ALC - extremely high mag. | |||
</gallery> | |||
==IHC== | ==IHC== | ||
Latest revision as of 05:45, 20 April 2016
| Atypical lung carcinoid tumour | |
|---|---|
| Diagnosis in short | |
 Atypical lung carcinoid tumour. H&E stain. | |
|
| |
| Synonyms | atypical carcinoid, atypical lung carcinoid, atypical pulmonary carcinoid |
| LM DDx | small cell carcinoma of the lung, carcinoid lung tumour, pulmonary carcinoid tumourlet, lung adenocarcinoma, metastatic small cell carcinoma |
| IHC | Ki-67 ~17% (range 10-26%) |
| Site | lung - see lung tumours |
|
| |
| Prognosis | moderate; poor vis-à-vis typical carcinoid |
| Clin. DDx | other lung tumours |
| Treatment | surgical resection +/-chemotherapy |
Atypical carcinoid lung tumour, also atypical carcinoid, is an uncommon lung tumour with a poor outcome.
General
- Approximately 20% of lung carcinoids.[1]
Prognosis:
- Significantly worse than for typical carcinoids; in one series,[2] the five year survival was 95% and 45% for typical carcinoid and atypical carcinoid respectively.
Treatment:
- Surgery for diagnosis and treatment.
- Chemotherapy for advanced/metastatic disease.[3]
Microscopic
Features:[4]
- Nests of cells.
- Stippled chromatin.
- Mild-to-moderate amount of cytoplasm.
- No necrosis/focal necrosis.
- Moderate mitotic rate (2-10/HPF - definition suffers from HPFitis).
DDx:
- Typical carcinoid lung tumour.
- Small cell carcinoma of the lung.
- Metastatic small cell carcinoma.
- Lung adenocarcinoma.
Images
ALC - low mag.
ALC - intermed. mag.
ALC - high mag.
ALC - very high mag.
ALC - high mag.
ALC - very high mag.
ALC - extremely high mag.
IHC
- Ki-67 ~17% (range 10-26%).[5]
Note:
- Typical carcinoid is considerably lower ~2% (range 0-7%) and large cell neuroendocrine considerable higher ~81% (range 63-92%).[5]
See also
References
- ↑ Naalsund, A.; Rostad, H.; Strøm, EH.; Lund, MB.; Strand, TE. (Apr 2011). "Carcinoid lung tumors--incidence, treatment and outcomes: a population-based study.". Eur J Cardiothorac Surg 39 (4): 565-9. doi:10.1016/j.ejcts.2010.08.036. PMID 20888248.
- ↑ Ayadi-Kaddour, A.; Marghli, A.; Zairi, S.; Zribi, H.; Ismail, O.; Braham, E.; Hantous-Zannad, S.; Kilani, T. et al. (Dec 2015). "[Bronchopulmonary carcinoid tumors: Tunisian experience with 115 surgically treated cases].". Rev Pneumol Clin 71 (6): 319-26. doi:10.1016/j.pneumo.2015.04.003. PMID 26195112.
- ↑ Chong, CR.; Wirth, LJ.; Nishino, M.; Chen, AB.; Sholl, LM.; Kulke, MH.; McNamee, CJ.; Jänne, PA. et al. (Nov 2014). "Chemotherapy for locally advanced and metastatic pulmonary carcinoid tumors.". Lung Cancer 86 (2): 241-6. doi:10.1016/j.lungcan.2014.08.012. PMID 25218177.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 115. ISBN 978-0781765275.
- ↑ 5.0 5.1 Liu, SZ.; Staats, PN.; Goicochea, L.; Alexiev, BA.; Shah, N.; Dixon, R.; Burke, AP. (2014). "Automated quantification of Ki-67 proliferative index of excised neuroendocrine tumors of the lung.". Diagn Pathol 9: 174. doi:10.1186/s13000-014-0174-z. PMID 25318848.