Atypical lung carcinoid tumour
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Atypical carcinoid lung tumour, also atypical carcinoid, is an uncommon lung tumour with a poor outcome.
| Atypical lung carcinoid tumour | |
|---|---|
| Diagnosis in short | |
 Atypical lung carcinoid tumour. H&E stain. | |
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| |
| 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 |
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.