Atypical lung carcinoid tumour

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Atypical lung carcinoid tumour
Diagnosis in short

Atypical lung carcinoid tumour. H&E stain.

Synonyms atypical carcinoid, atypical pulmonary lung 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

Clin. DDx other lung tumours

Atypical carcinoid lung tumour, also atypical carcinoid, is an uncommon lung tumour with a poor outcome.

General

Treatment:

  • Surgery for diagnosis and treatment.
  • Chemotherapy for advanced/metastatic disease.[2]

Microscopic

Features:[3]

  • 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:

Images

IHC

  • Ki-67 ~17% (range 10-26%).[4]

Note:

  • Typical carcinoid is considerably lower ~2% (range 0-7%) and large cell neuroendocrine considerable higher ~81% (range 63-92%).[4]

See also

References

  1. 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.
  2. 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.
  3. 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.
  4. 4.0 4.1 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.