NEURO-ENDOCRINE NEOPLASMS OF THE BRONCHOPULMONARY TRACT - A CLASSIFICATION OF THE SPECTRUM OF CARCINOID TO SMALL CELL-CARCINOMA AND INTERVENING VARIANTS

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  • 1 January 1985
    • journal article
    • research article
    • Vol. 89  (6) , 819-825
Abstract
Primary pulmonary neuroendocrine neoplasms (81) were assessed by the classification of Gould and associates. The neuroendocrine features of these tumors were studied by a combination of conventional light microscopy, EM and immunohistochemical staining for hormonal substances and neuron-specific enolase. In each case, clinical follow-up was obtained to test the prognostic value of this new pathological classification. Bronchial carcinoids apparently are very low-grade neuroendocrine neoplasms that are locally invasive and only occasionally metastasize late in their course. Well-differentiated neuroendocrine carcinomas are relatively low-grade carcinomas that either present with or subsequently develop nodal or distant metastases in 73% of patients. Intermediate cell neuroendocrine carcinomas are highly aggressive tumors often mistakenly called large cell undifferentiated carcinoma. Their clinical course is comparable to that of small cell neuroendocrine carcinomas, which has a mean survival of 9 mo. The different clinical courses of these tumors demonstrate the predictive value of the proposed classification. It appears particularly valuable to identify well-differentiated neuroendocrine carcinoma as a low-grade carcinoma, distinct from true bronchical carcinoids. This classification may resolve some discrepancies regarding the therapy for and prognosis of carcinoids and their presumed variants.

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