Diagnosis and treatment of bronchial carcinoid tumors: clinical and pathological review of 120 operated patients

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Abstract
Clinical and pathological review is presented of 120 patients operatedon for bronchial carcinoid tumors between 1976 and 1986. The usualoncologic features were analyzed. The Grimelius reaction,immunohistochemical staining for neuron specific enolase (NSE), serotoninand chromogranin, and DNA-analysis by flow cytometry were performed inthese tumors and in small cell lung cancers (SCLC). In our experience theusual oncologic criteria--atypia, tumor-size, localization, history andregional lymph node metastasis--fail to give clear information for theprognosis. The Grimelius reaction has no significant differentialdiagnostic importance. Immunostaining for NSE can aid in distinguishingbetween neuroendocrine and non-neuroendocrine pulmonary tumors. Thecarcinoids and SCLCs could be differentiated by immunostaining forchromogranin and by flow cytometry but none of these methods are suitablefor differential diagnosis within the carcinoid group. Resection bythoracotomy is the only treatment of choice: it can provide an excellentresult (the 5-year survival rate is above 90%) with a low hospitalmortality (0.8%). Parenchyma-sparing resections are to be encouraged.

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