CASE REPORT
Are there sufficient diagnostic criteria for bronchial atypical carcinoid? A case report of bronchial pigmented spindle cell carcinoid with a review of the literature
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Submission date: 2014-07-24
Final revision date: 2014-08-14
Acceptance date: 2014-08-19
Publication date: 2014-09-19
Medical Studies 2014;30(3):203-206
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ABSTRACT
Here we present a case of a 42-year-old female patient with pigmented spindle cell variant of bronchial carcinoid. The aim of this study was not only to record a rare variant of this tumour but also to highlight the differences in diagnostic criteria of gastrointestinal and bronchopulmonary-thymic neuroendocrine neoplasms. Ki-67 index is a discriminating factor in differential diagnosis between gastrointestinal neuroendocrine tumours (NETs) and, only optionally, in bronchopulmonary-thymic tumours. Since diagnosis is currently based on mitotic activity, optionally Ki-67 index and tumour necrosis, a rare variant of NET, spindle cell carcinoids with cellular atypia could be potential pitfalls for diagnostic controversies or mistakes. Nevertheless, the presented case of typical carcinoid with spindle cell component and mild to moderate cellular atypia has been classified according current WHO criteria as a typical carcinoid.
REFERENCES (13)
1.
Hörsch D, Schmid KW, Anlauf M, et al. Neuroendocrine tumors of the bronchopulmonary system (typical and atypical carcinoid tumors): current strategies in diagnosis and treatment. Conclusions of an expert meeting February 2011 in Weimar, Germany. Oncol Res Treat 2014; 37: 266-76.
2.
Naalsund A, Rostad H, Strøm EH, et al. Carcinoid lung tumors – incidence, treatment and outcomes: a population-based study. Eur J Cardiothorac Surg 2011; 39: 565-9.
3.
Gustafsson BI, Kidd M, Chan A, et al. Bronchopulmonary neuroendocrine tumors. Cancer 2008; 113: 5-21.
4.
Rindi G, Klersy C, Inzani F, et al. Grading the neuroendocrine tumors of the lung: an evidence-based proposal. Endocr Relat Cancer 2013; 21: 1-16.
5.
Phan AT, Oberg K, Choi J, et al.; North American NeuroendocrineTumor Society (NANETS). NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiatedneuroendocrine tumors of the thorax (includes lung and thymus). Pancreas 2010; 39: 784-98.
6.
Maurizi G, Ibrahim M, Andreetti C, et al. Long-term results after resection of bronchial carcinoid tumour: evaluation of survival and prognostic factors. Interact Cardiovasc Thorac Surg 2014 2014; 19: 239-44.
7.
Wu BS, Hu Y, Sun J, et al. Analysis on the characteristics and prognosis of pulmonary neuroendocrine tumors. Asian Pac J Cancer Prev 2014; 15: 2205-10.
8.
Cańizares MA, Matilla JM, Cueto A, et al. Atypical carcinoid tumours of the lung: prognostic factors and patterns of recurrence. Thorax 2014; 69: 648-53.
9.
Aydin E, Yazici U, Gulgosteren M, et al. Long-term outcomes and prognostic factors of patients with surgically treated pulmonary carcinoid: our institutional experience with 104 patients. Eur J Cardiothorac Surg 2011; 39: 549-54.
10.
Davini F, Gonfiotti A, Comin C, et al. Typical and atypical carcinoid tumours: 20-year experience with 89 patients. J Cardiovasc Surg (Torino) 2009; 50: 807-11.
11.
Panko S, Karpitski A, Shelepen K, et al. Epidemiology, diagnostics and long-term overall survival of patients with non-small cell lung cancer in the Brest Region. Studia Medyczne 2013; 29: 203-12.
12.
Walts AE, Ines D, Marchevsky AM. Limited role of Ki-67 proliferative index in predicting overall short-term survival in patients with typical and atypical pulmonary carcinoid tumors. Mod Pathol 2012; 25: 1258-64.
13.
Warth A, Fink L, Fisseler-Eckhoff A. et al.; Pulmonary Pathology Working Group of the German Society of Pathology. Interobserver agreement of proliferation index (Ki-67) outperforms mitotic count in pulmonary carcinoids. Virchows Arch 2013; 462: 507-13.