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Difference between revisions of "Atypical lung carcinoid tumour"
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Atypical lung carcinoid tumour (view source)
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Atypical lung carcinoid -- intermed mag.jpg | |||
| Width = | |||
| Caption = Atypical lung carcinoid tumour. [[H&E stain]]. | |||
| Synonyms = atypical carcinoid, atypical lung carcinoid, atypical pulmonary carcinoid | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[small cell carcinoma of the lung]], [[carcinoid lung tumour]], [[pulmonary carcinoid tumourlet]], [[lung adenocarcinoma]], metastatic [[small cell carcinoma]] | |||
| Stains = | |||
| IHC = Ki-67 ~17% (range 10-26%) | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Staging = | |||
| Site = [[lung]] - see ''[[lung tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = moderate; poor vis-à-vis typical carcinoid | |||
| Other = | |||
| ClinDDx = other [[lung tumours]] | |||
| Tx = surgical resection +/-chemotherapy | |||
}} | |||
'''Atypical carcinoid lung tumour''', also '''atypical carcinoid''', is an uncommon [[lung tumours|lung tumour]] with a poor outcome. | |||
==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> | |||
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== | |||
Features:<ref name=Ref_WMSP115>{{Ref WMSP|115}}</ref> | |||
*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=== | |||
<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== | |||
*Ki-67 ~17% (range 10-26%).<ref name=pmid25318848>{{Cite journal | last1 = Liu | first1 = SZ. | last2 = Staats | first2 = PN. | last3 = Goicochea | first3 = L. | last4 = Alexiev | first4 = BA. | last5 = Shah | first5 = N. | last6 = Dixon | first6 = R. | last7 = Burke | first7 = AP. | title = Automated quantification of Ki-67 proliferative index of excised neuroendocrine tumors of the lung. | journal = Diagn Pathol | volume = 9 | issue = | pages = 174 | month = | year = 2014 | doi = 10.1186/s13000-014-0174-z | PMID = 25318848 }}</ref> | |||
Note: | |||
*[[Typical lung carcinoid tumour|Typical carcinoid]] is considerably lower ~2% (range 0-7%) and large cell neuroendocrine considerable higher ~81% (range 63-92%).<ref name=pmid25318848/> | |||
==See also== | |||
*[[Lung tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Pulmonary pathology]] | |||