Typical and atypical pulmonary carcinoid tumor overdiagnosed as small-cell carcinoma on biopsy specimens: A major pitfall in the management of lung cancer patients

Giuseppe Pelosi, Jaime Rodriguez, Giuseppe Viale, Juan Rosai

Research output: Contribution to journalArticlepeer-review

Abstract

Seven patients with typical or atypical pulmonary carcinoid tumors overdiagnosed as small-cell carcinoma on bronchoscopic biopsies are described. Bronchial biopsies from 9 consecutive small-cell lung carcinoma patients were used as control group for histologic and immunohistochemical studies (cytokeratins, chromogranin A, synaptophysin, Ki-67 [MIB-1], and TTF-1). The carcinoid tumors presented as either central or peripheral lesions composed of tumor cells with granular, sometimes coarse chromatin pattern, high levels of chromogranin A/synaptophysin immunoreactivity, and low (50%) Ki-67 (MIB-1) labeling index. The stroma contained thick-walled blood vessels with glomeruloid configuration. Judging from this study, overdiagnosis of carcinoid tumor as small-cell carcinoma in small crushed bronchial biopsies remains a significant potential problem in a worldwide sample of hospital settings. Careful evaluation of hematoxylin and eosin sections remains the most important tool for the differential diagnosis, with evaluation of tumor cell proliferation by Ki-67 (MIB-1) labeling index emerging from our review as the most useful ancillary technique for the distinction.

Original languageEnglish
Pages (from-to)179-187
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number2
DOIs
Publication statusPublished - Feb 2005

Keywords

  • Carcinoid
  • Ki-67
  • Lung
  • Small-cell carcinoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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