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Endocrine Tumors of the Lung and Upper Airways

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Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Neuroendocrine tumors stand alone among other members of the larger family of tumors of the lung and upper airways. While relatively uncommon, they have, over the years, been the subject of considerable attention and study. A recent search of the literature yielded thousands of citations for small cell carcinoma, a single entity within the spectrum of neuroendocrine tumors. This chapter discusses the intriguing putative role of neuroendocrine cell hyperplasia as a possible precursor of these tumors. In addition, this chapter explores the similarities as well as differences between neuroendocrine and non-neuroendocrine tumors. Lastly, this chapter attempts to provide concise up-to-date information on both current, consensus –based morphologic criteria and the application of modern techniques, particularly immunohistochemical techniques that may facilitate histopathological diagnosis.

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References

  1. Oberndorfer S. (1907) Karzinoide Tumoren des diinndarms. Frankfurt Zeitschr Pathol 1:426–432.

    Google Scholar 

  2. World Health Organization Classification of Tumors. (2004) Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. In: WD Travis, E Brambila, HK Müller-Hermelink and CC Harris, Eds. Pathology and Genetics, Head and Neck Tumours. IARC Press. Lyon.

    Google Scholar 

  3. L Barnes. (2005) Neuroendocrine Tumors. In: L Barnes, JW Eveson, P Reichart and D Sidransky, Eds. World Health Organization Classification of Tumours. Pathology and Genetics. Head and Neck Tumours. IARC Press. Lyon, pp. 135–139.

    Google Scholar 

  4. Soga J, Ferlito A, Rinaldo A. (2004) Endocrine carcinomas (Carcinoids and their variants of the larynx): A comparative consideration with those of other sites. Oral Oncol 40:668–672.

    Article  PubMed  Google Scholar 

  5. El-Naggar AK, Batsakis JG. (1991) Carcinoid tumor of the larynx: A critical review of the literature. ORL J Otorhinolaryngol Relat Spec 53:188–193.

    Article  PubMed  CAS  Google Scholar 

  6. Aguayo SM, Miller YE, Waldron JA et al. (1992) Brief report: Idiopathic diffuse hyperplasia of pulmonary neuroendocrine cells and airways disease. NEJM 18:1285–1288.

    Article  Google Scholar 

  7. Kerr KM and Fraire AE 2008. Ch 34. Preinvasive Disease. In: JF Tomshefski, PT Cagle, C Farver and AE Fraire, Eds. Dail and Hammar Pulmonary Pathology, 3rd Ed. Springer. New York Berlin Heidelberg, pp. 158–215.

    Chapter  Google Scholar 

  8. Feyrter F. (1938) Ueber diffuse endokrine epitheliate organe. Zentralbl Inn Med 59:545–561.

    Google Scholar 

  9. Gould VE, Dellelis RA. (1983) The neuroendocrine cell system: Its tumors, hyperplasia and dysplasia. In: SG Silverberg, Ed. Principles and Practice of Surgical Pathology. Wiley. New York, 1:488–1501.

    Google Scholar 

  10. Pearse AGE. (1969) The cytochemistry and ultrastructure of polypeptide hormone-producing cells of the APUD series and the embryologic, physiologic and pathologic implications of this concept. J Histochem Cytochem 17:303–313.

    Article  PubMed  CAS  Google Scholar 

  11. Boers JE, den Brok JLM, Koudtaal J et al. (1996) Number and proliferation of neuroendocrine cells in normal human airway epithelium. Am J Respir Crit Care Med 154:758–763.

    PubMed  CAS  Google Scholar 

  12. Hammar SP. (1993) Ch 32 Common Neoplasms. In: DH Dail and SP Hammar, Eds. Pulmonary Pathology 2nd Ed. Springer-Verlag. Berlin New York Heidelberg, pp. 1123–1278.

    Google Scholar 

  13. Gould VE, Moll R, Moll I, Lee I, Franke WW. (1985) Neuroendocrine (Merkel) cells of the skin: hyperplasias, dysplasias and neoplasms. Lab Invest 52:334–353.

    PubMed  CAS  Google Scholar 

  14. Hasleton PS, Curry A. (1996) Anatomy of the lung. In: P.S. Hasleton, Ed. Spencer’s Pathology of the Lung. Fifth Ed. McGraw-Hill, New York, St. Louis, San Francisco, pp. 1–44.

    Google Scholar 

  15. Said JW, Vimadalal S, Nash G, et al. (1985) Immunoreactive neuron-specific enolase, bombesin, and chromogranin as markers for neuroendocrine lung tumors. Hum Pathol 16:236–240.

    Article  PubMed  CAS  Google Scholar 

  16. Connor DT, Deftos LJ. (1986) Secretion of chromogranin A by peptide-producing endocrine neoplasms. N Engl J Med 314:1145–1151.

    Article  Google Scholar 

  17. Armas OA, White DA, Erlandson RA et al. (1995) Diffuse idiopathic pulmonary neuroendocrine cell proliferation presenting as interstitial lung disease. Amer J Surg Pathol 19:963–970.

    Article  CAS  Google Scholar 

  18. Brown MJ, English J, Müller NL. (1997) Bronchiolitis obliterans due to neuroendocrine hyperplasia. CT-pathologic correlation. Am J Roentgenol 168:1561–1562.

    CAS  Google Scholar 

  19. Lee JS, Brown KK, Cool C, Lynch DA. (2002) Diffuse pulmonary cell hyperplasia: Radiologic and clinical features. J Comput Assist Tomogr 26:180–184.

    Article  PubMed  Google Scholar 

  20. Sheerin N, Harrison NK, Sheppard MN et al. (1995) Obliterative bronchiolitis caused by multiple tumourlets and microcarcinoids successfully treated by single lung transplantation. Thorax 50,207–209.

    Article  PubMed  CAS  Google Scholar 

  21. Gosney JR. (2004) Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia as a precursor to pulmonary neuroendocrine tumors. Chest 125:108S.

    Article  PubMed  Google Scholar 

  22. Whitwell F. (1955) Tumourlets of the lung. J Pathol Bact 70:529–541.

    Article  CAS  Google Scholar 

  23. Churg A, Warnock ML. (1976) Pulmonary tumorlet. A form of peripheral carcinoid. Cancer 37:1469–1477.

    Article  PubMed  CAS  Google Scholar 

  24. Gmelich JT, Bensch KG, Liebow AA. (1967) Cells of Kulchitsky type in bronchioles and their relation to the origin of peripheral carcinoid tumours. Lab Invest 17:88–98.

    PubMed  CAS  Google Scholar 

  25. Pelosi IG, Zancanaro C, Sbubo L, Bresaola E, Martignoni G, Bontempini L. (1992) Development of innumerable neuroendocrine tumorlets in pulmonary lobe scarred by intralobar sequestration: Immunohistochemical and ultrastructural study of an unusual case. Arch Pathol Lab Med 116:1167–1174.

    PubMed  CAS  Google Scholar 

  26. Neuroendocrine neoplasms. (1999) Ch 32 In: RS Fraser, N Colman, NL Müller and PD Paré, Eds. Fraser and Paré’s Diagnosis of Diseases of the Chest, 4th Ed. WB Saunders, Philadelphia, London, Toronto, pp. 1229–1261.

    Google Scholar 

  27. Hausman DH, Weimann RB. (1967) Pulmonary tumourlet with hilar lymph node metastases. Cancer 20:1515–1519.

    Article  PubMed  CAS  Google Scholar 

  28. D’Agati VD, Perzin KH. (1985) Carcinoid tumorlets of the lung with metastasis to a periobronchial lymph node. Report of a case and review of the literature. Cancer 55:2472–2476.

    Article  PubMed  Google Scholar 

  29. Cohen AJ, King TE, Gilman LB et al. (1998) High expression of neutral endopeptidase in idiopathic diffuse hyperplasia of pulmonary neuroendocrine cells. Am J Respir Crit Care Med 158:1593–1599.

    PubMed  CAS  Google Scholar 

  30. Beasley M, Thunnissen FB, Hasleton PhS et al. (2004) Carcinoid tumour. In: WD, Brambilla AE, Müller-Hermelink HK and Harris CC, Eds. Pathology and genetics of tumours of the lung, pleura, thymus and heart. Travis. IARC Press, Lyon, pp. 59–62.

    Google Scholar 

  31. Ranchod M, Levine GD. (1980) Spindle cell carcinoid tumors of the lung: a clinicopathologic study of 35 cases. Am J Surg Pathol 4:315–331.

    Article  PubMed  CAS  Google Scholar 

  32. Abdi EA, Goel R, Bishop S et al. (1988) Peripheral carcinoid tumours of the lung. A clinicopathologic study. J Surg Oncol 39:190–196.

    Article  PubMed  Google Scholar 

  33. Klemen H, Smolle-Jüttner FM, Popper HH. 1994 Morphologic and immunohistochemical study of typical and atypical carcinoids of the lung, on the basis of 55 cases with clinical correlation of a new classification. Endocrine-Related Cancer 1:53–62.

    Article  Google Scholar 

  34. Moran CA, Suster S. (2000) Neuroendocrine Carcinomas: In: CDM Fletcher, Ed. Diagnostic Histopathology of Tumors, 2nd Ed. Churchill Livingstone. London Edinburgh New York, pp. 176–179.

    Google Scholar 

  35. Mark EJ, Quay SC, Dickersin GR. (1981) Papillary carcinoid tumor of the lung. Cancer (Philadelphia) 48:316–324.

    Article  CAS  Google Scholar 

  36. Ghadially FN, Block HJ. (1985) Oncocytic carcinoid of the lung. J Submicrosc Cytol 17:435–442.

    PubMed  CAS  Google Scholar 

  37. Gaffey MJ, Mills SE, Frierson HF Jr, et al. (1998) Pulmonary clear cell carcinoid tumor; another entity in the differential diagnosis of pulmonary clear cell neoplasia. Am J Surg Pathol 22:1020–1025.

    Article  PubMed  CAS  Google Scholar 

  38. Bonikos DS, Bensch KG, Jamplis RW. (1976) Peripheral pulmonary carcinoid tumours. Cancer 37:1977–1998.

    Article  PubMed  CAS  Google Scholar 

  39. Okike N, Bernatz PE, Woolner LB. (1976) Carcinoid tumors of the lung. Ann Thorac Surg 22:270–275.

    Article  PubMed  CAS  Google Scholar 

  40. Beasley MB. (2008) Part 7, Atypical Carcinoids. In: PT Cagle Chief, Ed. Color Atlas and text of pulmonary pathology. The Wolters Kluwer Co. Philadelphia, Baltimore, New York, pp. 58–59.

    Google Scholar 

  41. Kaufmann O, Dietel M. (2000) Expression of thyroid transcription factor-1 in pulmonary and extrapulmonary small cell carcinomas and other neuroendocrine carcinomas of various primary sites. Histopathology 36:415–420.

    Article  PubMed  CAS  Google Scholar 

  42. Fukayama M, Furukawa E, Shiozawa Y et al. (1990) Atypical endocrine granules in atypical endocrine tumor (AET) of the lung. Acta Pathol Jpn 40:361–366.

    PubMed  CAS  Google Scholar 

  43. Ullmann R, Petzmann S, Klemen H et al. (2002) The position of lung carcinoids within the spectrum of neuoendocrine tumors of the lung and other tissues. Genes Chromosomes Cancer 34:78–85.

    Google Scholar 

  44. Arrigoni MG, Woolner LB, Bernatz PE. (1972) Atypical carcinoid tumors of the lung. J Thorac Cardiovasc Surg 64:413–421.

    PubMed  CAS  Google Scholar 

  45. Warren WH, Gould VE. (1990) Long term follow-up of clinical bronchial carcinoid tumors: Clinicopathologic Observations. Scand. J. Thorac Cardiovasc Surg 24:125–130.

    Article  PubMed  CAS  Google Scholar 

  46. Slodkowska J, Langfort R, Rudzinski P et al. (1998) Typical and atypical carcinoids – Pathologic and clinical analysis of 77 cases. Pneumol Alergol Pol 66:297–303.

    CAS  Google Scholar 

  47. Hirsch MS, Faquin WC, Krane JF (2004) Thyroid transcription factor – 1 but not p53 is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid. Modern Pathol 17:631–636.

    Article  CAS  Google Scholar 

  48. Takei H, Asamura H, Maeshima A et al. (2002) Large cell neuroendocrine carcinoma of the lung: Clinicopathologic study of eighty seven cases. J Thorac Cardiovasc Surg 124:285–292.

    Article  PubMed  Google Scholar 

  49. Pathology of the Lungs. (2000) Corrin B, Editor in Chief. Churchill Livingstone, London Edinburgh, New York, pp. 479–480.

    Google Scholar 

  50. Visscher DW, Zarbo RJ, Trojanowski JW, Sakr W, Crissman JD. (1990) Neuroendocrine differentiation in poorly differentiated lung carcinomas. A light microscopic and immunohistologic study. Mod Pathol 3:508–512.

    PubMed  CAS  Google Scholar 

  51. Wick M, Berg L, Hertz M. (1992) Large cell carcinoma of the lung with neuroendocrine differentiation. A comparison with large cell “undifferentiated” pulmonary tumors. Am J Clin Pathol 97:796–805.

    PubMed  CAS  Google Scholar 

  52. Travis WD. (2004) The concept of pulmonary neuroendocrine tumours. In: WD Travis, E. Brambilla, HK Müller-Hermelink and CC Harris, Eds. World Health Organization Classification of Lung Tumours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. IARC Press, Lyon, pp. 19–20.

    Google Scholar 

  53. Akata S, Okada S, Maeda J et al. (2007) Computed tomographic findings in large cell neuroendocrine carcinoma of the lung. Clin Imaging 31:379–384.

    Article  PubMed  Google Scholar 

  54. Sica G, Vasquez MF, Altorki N et al. (2008) PAX-5 expression in pulmonary neuroendocrine carcinomas: its usefulness in surgical and fine-needle aspiration biopsy specimens. Am J Clin Pathol 129:556–562.

    Article  PubMed  Google Scholar 

  55. Butnor KJ, Burchette JL, Sporn TA et al. (2004) The spectrum of c-kit (CD117) immunoreactivity in lung and pleural tumors: A study of 96 cases using a single source antibody with a review of the literature. Arch Pathol Lab Med 128:538–543.

    PubMed  Google Scholar 

  56. D’Adda T, Pelosi G, Lagrasta C et al. (2008) Genetic alterations in combined neuroendocrine neoplasms of the lung. Mod Pathol 21:414–422.

    Article  PubMed  Google Scholar 

  57. Travis W, Nicholson S, Hirsch FR et al. (2004) Small Cell Carcinoma. In: WD Travis, E Brambilla, HK Müller-Hermelink and CC Harris, Eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. IARC Press Lyon, pp. 31–34.

    Google Scholar 

  58. Hirsch FR, Matthews MJ, Aisner S, et al. (1988) Histopathologic classification of small cell lung cancer: changing concepts and terminology. Cancer 62:973–977.

    Article  PubMed  CAS  Google Scholar 

  59. Fraire AE, Johnson EH, Yesner R, Zhang XB, Spjut HJ, Greenberg SD. (1992) Prognostic significance of histopathologic subtype and stage in small cell lung cancer. Hum Pathol 23:520–528.

    Article  PubMed  CAS  Google Scholar 

  60. Mark EJ, Ramirez JF. (1985) Peripheral small-cell carcinoma of the lung resembling carcinoid tumor: A clinical and pathologic study of 14 cases. Arch Pathol Lab Med 109:263–269.

    PubMed  CAS  Google Scholar 

  61. Kreisman H, Wolkove N, Quoix E. (1992) Small cell lung cancer presenting as a solitary pulmonary nodule. Chest 101:225–229.

    Article  PubMed  CAS  Google Scholar 

  62. Azzopardi JG (1959) Oat cell carcinoma of the bronchus. J Pathol Bacteriol 78:513–519.

    Article  PubMed  CAS  Google Scholar 

  63. Kontogiannis K, Nicholson AG, Butcher D et al. (2005) CD 56: A useful tool for the diagnosis of small cell lung carcinomas on biopsies with extensive crush artifact. J Clin Pathol 58:978–980.

    Article  Google Scholar 

  64. Aslan DL, Gulbahce HE, Pambuccian SE et al. (2005) Ki-67 immunoreactivity in the differential diagnosis of pulmonary neuroendocrine neoplasms in specimens with extensive crush artifact. Am J Clin Pathol 123:874–878.

    Article  PubMed  CAS  Google Scholar 

  65. Marchevsky AM, Gal AA, Shah S, et al. (2001) Morphometry confirms the presence of considerable nuclear size overlap between “small cells” and “large cells” in high-grade pulmonary neuroendocrine neoplasms. Am J Clin Pathol 116:466–472.

    Article  PubMed  CAS  Google Scholar 

  66. Zhang H, Liu J, Cagle PT et al. (2005) Distinction of pulmonary small cell carcinoma from poorly differentiated squamous cell carcinoma: An immunohistochemical approach. Modern Pathol 18:111–118.

    Article  CAS  Google Scholar 

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Correspondence to Armando E. Fraire .

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Fraire, A.E., Gruber-Mösenbacher, U.M., Popper, H.H. (2009). Endocrine Tumors of the Lung and Upper Airways. In: Khan, A. (eds) Surgical Pathology of Endocrine and Neuroendocrine Tumors. Current Clinical Pathology. Humana Press. https://doi.org/10.1007/978-1-60327-396-1_10

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  • DOI: https://doi.org/10.1007/978-1-60327-396-1_10

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