A variety of carcinomas with neuroendocrine features may arise in the lung. These range from the typical carcinoid to small cell, undifferentiated carcinomas, with a prognosis ranging from fairly good to poor.
Morphologic patterns seen with carcinoid tumors:
(1) organoid nesting
(2) palisading
(3) rosettes
(4) trabeculae
Features of neuroendocrine tumors:
(1) neuroendocrine granules on electron microscopy
(2) one or more immunohistochemical markers: chromogranin, synaptophysin, Leu-7
|
Tumor |
Appearance |
Mitoses in 10 HPF |
Necrosis |
|
typical carcinoid |
carcinoid morphology |
< 2 |
none |
|
atypical carcinoid |
carcinoid morphology, with mitotic rate OR necrosis |
2 to 10 |
necrosis, usually punctate |
|
large cell neuroendocrine carcinoma |
large cell size with more abundant cytoplasm; nuclei have a fine or vesicular chromatin and may or may not show nucleoli |
>= 11, median 70 |
frequent, areas may be large |
|
small cell undifferentiated carcinoma |
cells usually small with scant cytoplasm; nuclei have a finely granular chromatin with absent or faint nucleoli |
>= 11, median 80 |
frequent, areas may be large |
where:
• The area of 10 high powered fields (HPF) used in the paper is 2 square mm.
|
Tumor |
Risk |
5 Year Survival |
|
typical carcinoid |
low |
85% |
|
atypical carcinoid |
intermediate |
55% |
|
large cell neuroendocrine carcinoma |
high |
20% |
|
small cell undifferentiated carcinoma |
high |
8% |
after Figure 1B, page 937, Travis 1998
Specialty: Hematology Oncology, Surgery, general, Pulmonology
ICD-10: ,
