Journal of Pathology and Translational Medicine

Case Studies

Primary testicular carcinoid tumor with marked lymphovascular invasion: Hyun Jung Lee, Joon Young Park, So Young Kim, Chung Su Hwang, Jung Hee Lee, Dong Hoon Shin, Jee Yeon Kim; J Pathol Transl Med. 2021;55(6):410-414. Published online October 20, 2021; DOI: https://doi.org/10.4132/jptm.2021.09.11

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Testicular carcinoid tumors are very rare, accounting for less than 1% of all testicular tumors. We report a rare case of a testicular carcinoid tumor with extensive lymphatic invasion. A 42-year-old man presented with a painless, enlarged right testicular mass. There was no history of injury or discomfort in this region. Right radical orchiectomy was performed, which showed a well-defined, non-encapsulated solid white mass with calcification (7.0 × 4.5 × 3.5 cm) and absence of cystic components. Microscopic examination using hematoxylin and eosin staining of the tumor sections identified organoid, trabecular, and solid patterns with rosette formation. Extensive multifocal lymphatic invasion was observed. Immunohistochemistry was positive for synaptophysin, chromogranin, and CD56. Testicular carcinoid tumors usually show good prognoses; however, there was extensive lymphovascular invasion in this case. Thus, in the case of unusual presentation of the disease, close follow-up is necessary.

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Testicular Primary Well-Differentiated Neuroendocrine Tumor: Clinicopathologic, Immunohistochemical, and Molecular Characterization of Two Patients
Liwei Jia, Bo Zhang, Daniel Shen, Prasad R. Koduru
International Journal of Surgical Pathology.2024; 32(8): 1574. CrossRef

Primary carcinoid tumor in the external auditory canal: Dong Hae Chung, Gyu Cheol Han, Na Rae Kim; J Pathol Transl Med. 2020;54(2):184-187. Published online November 13, 2019; DOI: https://doi.org/10.4132/jptm.2019.11.07

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Abstract PDF

A 39-year-old man visited the department of otolaryngology due to an ongoing hearing disturbance that had lasted for 1 year. Temporal bone computed tomography revealed soft tissue density nearly obliterating the left external auditory canal (EAC). The mass was composed of sheets of round tumor cells containing moderate amounts of fine granular cytoplasm and salt and pepper chromatin. Neither mitosis nor necrosis was found. The Ki-67 proliferation index was less than 2%. Cells were positive for CD56 and synaptophysin but negative for chromogranin, cytokeratin (CK) 20, and CK7. Based on these findings, the tumor was diagnosed as a carcinoid tumor, well differentiated neuroendocrine carcinoma, grade 1 (G1) according to current World Health Organization (WHO) classification of head and neck tumors; and a neuroendocrine tumor, G1 according to neuroendocrine neoplasm (NEN)-2018 WHO standard classification. He remained free of local recurrence and metastasis after 20 months of follow up. To date, only six cases of primary NENs in the EAC have been reported. Metastatic tumor should be included in the differential diagnoses. Because of its rarity, the prognosis and treatment have not yet been clarified.

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Incidental finding of a neuroendocrine neoplasm in a suspected ear canal exostosis
Alexander Wieck Fjaeldstad, Gerda Elisabeth Villadsen, Gitte Dam, Stephen Jacques Hamilton-Dutoit, Thomas Winther Frederiksen
Otolaryngology Case Reports.2022; 22: 100394. CrossRef
68Ga-DOTATATE Uptake in Well-Differentiated Neuroendocrine Tumor of the External Auditory Canal
Özge Erol Fenercioğlu, Ediz Beyhan, Rahime Şahin, Mehmet Can Baloğlu, Tevfik Fikret Çermik
Clinical Nuclear Medicine.2022; 47(8): e552. CrossRef

Original Articles

Morphologic Analysis of Pulmonary Neuroendocrine Tumors: Seung Seok Lee, Myunghee Kang, Seung Yeon Ha, Jungsuk An, Mee Sook Roh, Chang Won Ha, Jungho Han; Korean J Pathol. 2013;47(1):16-20. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.16

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Abstract PDF

Background

Few studies on how to diagnose pulmonary neuroendocrine tumors through morphometric analysis have been reported. In this study, we measured and analyzed the characteristic parameters of pulmonary neuroendocrine tumors using an image analyzer to aid in diagnosis.

Methods

Sixteen cases of typical carcinoid tumor, 5 cases of atypical carcinoid tumor, 15 cases of small cell carcinoma, and 51 cases of large cell neuroendocrine carcinoma were analyzed. Using an image analyzer, we measured the nuclear area, perimeter, and the major and minor axes.

Results

The mean nuclear area was 0.318±0.101 µm² in typical carcinoid tumors, 0.326±0.119 µm² in atypical carcinoid tumors, 0.314±0.107 µm² in small cell carcinomas, and 0.446±0.145 µm² in large cell neuroendocrine carcinomas. The mean nuclear circumference was 2.268±0.600 µm in typical carcinoid tumors, 2.408±0.680 µm in atypical carcinoid tumors, 2.158±0.438 µm in small cell carcinomas, and 3.247±1.276 µm in large cell neuroendocrine carcinomas. All parameters were useful in distinguishing large cell neuroendocrine carcinoma from other tumors (p=0.001) and in particular, nuclear circumference was the most effective (p=0.001).

Conclusions

Pulmonary neuroendocrine tumors showed nuclear morphology differences by subtype. Therefore, evaluation of quantitative nuclear parameters improves the accuracy and reliability of diagnosis.

Citations

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Clinical Significance of Persistent Tumor in Bone Marrow during Treatment of High-risk Neuroblastoma
Young Bae Choi, Go Eun Bae, Na Hee Lee, Jung-Sun Kim, Soo Hyun Lee, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo
Journal of Korean Medical Science.2015; 30(8): 1062. CrossRef
Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy
Go Eun Bae, Yeon-Lim Suh, Ki Woong Sung, Jung-Sun Kim
Korean Journal of Pathology.2013; 47(5): 433. CrossRef

Clinicopathological Analysis of 21 Thymic Neuroendocrine Tumors: Soomin Ahn, Jae Jun Lee, Sang Yun Ha, Chang Ohk Sung, Jhingook Kim, Joungho Han; Korean J Pathol. 2012;46(3):221-225. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.221

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Abstract PDF

Background

Thymic neuroendocrine carcinomas (NECs) are uncommon, for which there is no established information available because of a limited number of epidemiological study in Asia.

Methods

We reviewed 21 cases of surgically resected thymic NECs, and evaluated their pathological and clinical features.

Results

It showed male predominance (male/female ratio, 15/6) with wide age range from 20 to 72 years (mean age, 49 years). All 21 cases were divided into two types according to the World Health Organization criteria: atypical carcinoid (n=18) and large cell NEC (n=3). Three cases of atypical carcinoid (AC) were associated with ectopic Cushing's syndrome. All the patients (3/3) with large cell NEC (3/3) and 16.7% (3/18) of those with AC died of tumor progression. Common sites of metastasis included lung, lymph node, brain, lumbar spine, mediastinum, bone, and liver.

Conclusions

In conclusion, thymic neuroendocrine tumors carry a poor prognosis. Regarding the tumor classification, our results showed that a vast majority of carcinoids in the thymus correspond to ACs. In addition, our results also indicate that typical carcinoid is a very rare entity. Some cases of AC exhibited a large size, solid pattern and they showed aggressive clinical behavior, which highlights the spectrum of histologic appearances of thymic NECs.

Citations

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Neuroendocrine neoplasms of the thymus
Paul D. Barone, Chen Zhang
Frontiers in Immunology.2024;[Epub] CrossRef
Thymic neuroendocrine tumours
Jan von der Thüsen
Diagnostic Histopathology.2023; 29(2): 114. CrossRef
The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions
Uma Kundu, Qiong Gan, Deepak Donthi, Nour Sneige
Diagnostics.2023; 13(14): 2400. CrossRef
Paediatric and adolescent ectopic Cushing's syndrome: systematic review
Chethan Yami Channaiah, Manjiri Karlekar, Vijaya Sarathi, Anurag Ranjan Lila, Shruthi Ravindra, Padma Vikram Badhe, Gaurav Malhotra, Saba Samad Memon, Virendra Ashokrao Patil, C S Pramesh, Tushar Bandgar
European Journal of Endocrinology.2023; 189(4): S75. CrossRef
Multiple endocrine neoplasia type 1 (MEN-1) and neuroendocrine neoplasms (NENs)
Grigoris Effraimidis, Ulrich Knigge, Maria Rossing, Peter Oturai, Åse Krogh Rasmussen, Ulla Feldt-Rasmussen
Seminars in Cancer Biology.2022; 79: 141. CrossRef
Multiple electrolyte disturbances as the presenting feature of multiple endocrine neoplasia type 1 (MEN-1)
Adrian Po Zhu Li, Sheela Sathyanarayan, Salvador Diaz-Cano, Sobia Arshad, Eftychia E Drakou, Royce P Vincent, Ashley B Grossman, Simon J B Aylwin, Georgios K Dimitriadis
Endocrinology, Diabetes & Metabolism Case Reports.2022;[Epub] CrossRef
Metastatic Thymic Carcinoid: Does Surgeon Have a Primary Role?
Kumud Gupta, Ravindra K. Dewan, Vinitha Viswambharan Nair, Rajat Saxena, Shaleen Prasad
The Indian Journal of Chest Diseases and Allied Sciences.2022; 56(4): 255. CrossRef
A resected case of large cell neuroendocrine carcinoma of the thymus
Masashi Umeda, Takahiko Misao, Tomoya Senoh, Yoshinobu Shikatani, Motoi Aoe
The Journal of the Japanese Association for Chest Surgery.2022; 36(7): 766. CrossRef
Treatment strategy and prognostic analysis of spinal metastases from thymomas: A retrospective study from a single center
Shuzhong Liu, Xi Zhou, An Song, Zhen Huo, Siyuan Yao, Yipeng Wang, Yong Liu
Clinical Neurology and Neurosurgery.2020; 196: 106056. CrossRef
Large Cell Neuroendocrine Carcinoma of the Mediastinum Successfully Treated with Systemic Chemotherapy after Palliative Radiotherapy
Takeaki Hidaka, Saki Okuzumi, Ako Matsuhashi, Hidenori Takahashi, Kazunori Hata, Seiichiro Shimizu, Yoshinobu Iwasaki
Internal Medicine.2019; 58(4): 563. CrossRef
Surgical management of spinal metastases of thymic carcinoma
Shuzhong Liu, Xi Zhou, An Song, Zhen Huo, William A. Li, Radhika Rastogi, Yipeng Wang, Yong Liu
Medicine.2019; 98(3): e14198. CrossRef
Resected thymic large cell neuroendocrine carcinoma: A case report and review of the literature
Shogo Ogata, Ryo Maeda, Masaki Tomita, Yuichiro Sato, Takanori Ayabe, Kunihide Nakamura
International Journal of Surgery Case Reports.2019; 60: 53. CrossRef
Metastatic or locally advanced mediastinal neuroendocrine tumours
Aadil Adnan, Shreyas Kudachi, Sudha Ramesh, Kumar Prabhash, Sandip Basu
Nuclear Medicine Communications.2019; 40(9): 947. CrossRef
Results of treatment for thymic neuroendocrine tumours: multicentre clinicopathological study†
Naoko Ose, Hajime Maeda, Masayoshi Inoue, Eiichi Morii, Yasushi Shintani, Hiroshi Matsui, Hirohito Tada, Tositeru Tokunaga, Kenji Kimura, Yasushi Sakamaki, Yukiyasu Takeuchi, Kenjiro Fukuhara, Hiroshi Katsura, Teruo Iwasaki, Meinoshin Okumura
Interactive CardioVascular and Thoracic Surgery.2018; 26(1): 18. CrossRef
Patterns of Failure Following Postoperative Radiation Therapy Based on “Tumor Bed With Margin” for Stage II to IV Type C Thymic Epithelial Tumor
Kyung Hwa Lee, Jae Myoung Noh, Yong Chan Ahn, Dongryul Oh, Jhingook Kim, Young Mog Shim, Jung-ho Han
International Journal of Radiation Oncology*Biology*Physics.2018; 102(5): 1505. CrossRef
Resected thymic large cell neuroendocrine carcinoma: report of a case
Hiromitsu Domen, Yasuhiro Hida, Masaaki Sato, Haruka Takahashi, Tatsuru Ishikawa, Yosuke Shionoya, Midori Hashimoto, Kaoru Nishiyama, Yuma Aoki, Kazuho Inoko, Syotaro Furukawa, Kazuomi Ichinokawa, Hidehisa Yamada
Surgical Case Reports.2018;[Epub] CrossRef
Successful treatment of malignant thymoma with sacrum metastases
Shuzhong Liu, Xi Zhou, An Song, Zhen Huo, William A. Li, Radhika Rastogi, Yipeng Wang, Yong Liu
Medicine.2018; 97(51): e13796. CrossRef
Incidental metastatic mediastinal atypical carcinoid in a patient with parathyroid adenoma: a case report
Zareen Kiran, Asma Ahmed, Owais Rashid, Saira Fatima, Faizan Malik, Saulat Fatimi, Mubassher Ikram
Journal of Medical Case Reports.2017;[Epub] CrossRef
Thymus neuroendocrine tumors with CTNNB1 gene mutations, disarrayed ß-catenin expression, and dual intra-tumor Ki-67 labeling index compartmentalization challenge the concept of secondary high-grade neuroendocrine tumor: a paradigm shift
Alessandra Fabbri, Mara Cossa, Angelica Sonzogni, Paolo Bidoli, Stefania Canova, Diego Cortinovis, Maria Ida Abbate, Fiorella Calabrese, Nazarena Nannini, Francesca Lunardi, Giulio Rossi, Stefano La Rosa, Carlo Capella, Elena Tamborini, Federica Perrone,
Virchows Archiv.2017; 471(1): 31. CrossRef
Thymic large cell neuroendocrine carcinoma – a rare and aggressive tumor: a case report
Efared Boubacar, Gabrielle Atsame-Ebang, Sani Rabiou, Ammor Fatimazahra, Asmae Mazti, Ibrahim S. Sidibé, Layla Tahiri, Nawal Hammas, Ouadnouni Yassine, Smahi Mohamed, Chbani Laila, El Fatemi Hinde
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Clinicopathological features of neoplasms with neuroendocrine differentiation occurring in the liver
Yoriko Nomura, Osamu Nakashima, Jun Akiba, Sachiko Ogasawara, Shogo Fukutomi, Rin Yamaguchi, Hironori Kusano, Masayoshi Kage, Koji Okuda, Hirohisa Yano
Journal of Clinical Pathology.2017; 70(7): 563. CrossRef
Retrosternal goiter and thymic carcinoid: A rare co-existence
Abdulsalam Yaseen Taha, Nezar A. Almahfooz, Hassanain H. Khudair
Journal of the Egyptian Society of Cardio-Thoracic Surgery.2017; 25(4): 369. CrossRef
A case of large-cell neuroendocrine carcinoma of the thymus involving a patient with long-term survival after surgery
Qiuming Kan, Kohei Tagawa, Teruaki Ishida, Mitsuyo Nishimura, Katsuhiko Aoyama
The Journal of the Japanese Association for Chest Surgery.2017; 31(7): 927. CrossRef
Neuroendokrine Neoplasien des Mediastinums
L. Brcic, M. Heidinger, H. Popper
Der Pathologe.2016; 37(5): 434. CrossRef
Outcome of primary neuroendocrine tumors of the thymus: A joint analysis of the International Thymic Malignancy Interest Group and the European Society of Thoracic Surgeons databases
Pier Luigi Filosso, Xiaopan Yao, Usman Ahmad, Yilei Zhan, James Huang, Enrico Ruffini, William Travis, Marco Lucchi, Andreas Rimner, Alberto Antonicelli, Francesco Guerrera, Frank Detterbeck
The Journal of Thoracic and Cardiovascular Surgery.2015; 149(1): 103. CrossRef
Clinical Significance of Persistent Tumor in Bone Marrow during Treatment of High-risk Neuroblastoma
Young Bae Choi, Go Eun Bae, Na Hee Lee, Jung-Sun Kim, Soo Hyun Lee, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo
Journal of Korean Medical Science.2015; 30(8): 1062. CrossRef
Tumor genetics and survival of thymic neuroendocrine neoplasms: A multi‐institutional clinicopathologic study
Philipp Ströbel, Andreas Zettl, Konstantin Shilo, Wen‐Yu Chuang, Andrew G. Nicholson, Yoshihiro Matsuno, Anthony Gal, Rolf Hubert Laeng, Peter Engel, Carlo Capella, Mirella Marino, John Kwok-Cheung Chan, Andreas Rosenwald, William Travis, Teri J. Franks,
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Disseminated large cell neuroendocrine carcinoma associated with ectopic adrenocorticotropic hormone secretion
A Van der Walt, K Huddle, S Pather, A Korb
Journal of Endocrinology, Metabolism and Diabetes of South Africa.2014; 19(1): 40. CrossRef
Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy
Go Eun Bae, Yeon-Lim Suh, Ki Woong Sung, Jung-Sun Kim
Korean Journal of Pathology.2013; 47(5): 433. CrossRef

The Interobserver Variability for Diagnosing Pulmonary Carcinoid Tumor.: Chang Hun Lee, Hee Kyung Chang, Hyoun Wook Lee, Dong Hoon Shin, Mee Sook Roh; Korean J Pathol. 2010;44(3):267-271.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.267

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Abstract PDF

BACKGROUND
Although the grade of pulmonary carcinoid tumor is routinely reported in pathology practice, there is a paucity of data on the level of agreement between pathologists.
METHODS
Data for 30 cases of surgically resected pulmonary tumors diagnosed as carcinoid tumors (19 typical carcinoids [TCs] and 11 atypical carcinoids [ACs]) were retrieved from four university hospitals. These cases were independently evaluated by five pathologists and were classified according to the 2004 World Health Organization (WHO) classification. Agreement was regarded as "unanimous" if all five pathologists agreed, and as a "majority" if four agreed. The kappa statistic was calculated to measure the degree of agreement between pathologists.
RESULTS
Unanimous agreement was achieved for 50.0% and a majority agreement for 83.3% of the 30 cases. The range of the kappa values extended from 0.37 to 0.89. After a consensus meeting, there was disagreement between the original diagnosis by each institute and the consensus diagnosis by the five pathologists for 40.0% of the 30 cases. Based on the consensus diagnosis, the agreement was greater for TCs than that for ACs.
CONCLUSIONS
Discriminating carcinoid tumors is subject to interobserver variability. This study indicates that there is a need for more careful standardization and application of diagnostic criteria for making the diagnosis of pulmonary carcinoid tumor.

Citations

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Assessment of the current and emerging criteria for the histopathological classification of lung neuroendocrine tumours in the lungNENomics project
É. Mathian, Y. Drouet, A. Sexton-Oates, M.G. Papotti, G. Pelosi, J.-M. Vignaud, L. Brcic, A. Mansuet-Lupo, F. Damiola, C. Altun, J.-P. Berthet, C.B. Fournier, O.T. Brustugun, G. Centonze, L. Chalabreysse, V.T. de Montpréville, C.M. di Micco, E. Fadel, N.
ESMO Open.2024; 9(6): 103591. CrossRef
Limited additive value of the Ki‐67 proliferative index on patient survival in World Health Organization‐classified pulmonary carcinoids
Dorian R A Swarts, Martina Rudelius, Sandra M H Claessen, Jack P Cleutjens, Stefan Seidl, Marco Volante, Frans C S Ramaekers, Ernst J M Speel
Histopathology.2017; 70(3): 412. CrossRef
Interobserver Variability for the WHO Classification of Pulmonary Carcinoids
Dorian R.A. Swarts, Robert-Jan van Suylen, Michael A. den Bakker, Matthijs F.M. van Oosterhout, Frederik B.J.M. Thunnissen, Marco Volante, Anne-Marie C. Dingemans, Marc R.M. Scheltinga, Gerben P. Bootsma, Harry M.M. Pouwels, Ben E.E.M. van den Borne, Fran
American Journal of Surgical Pathology.2014; 38(10): 1429. CrossRef
Lung parenchymal invasion in pulmonary carcinoid tumor: An important histologic feature suggesting the diagnosis of atypical carcinoid and poor prognosis
Sang Yun Ha, Jae Jun Lee, Junhun Cho, Jiyeon Hyeon, Joungho Han, Hong Kwan Kim
Lung Cancer.2013; 80(2): 146. CrossRef
CD44 and OTP Are Strong Prognostic Markers for Pulmonary Carcinoids
Dorian R.A. Swarts, Mieke E.R. Henfling, Leander Van Neste, Robert-Jan van Suylen, Anne-Marie C. Dingemans, Winand N.M. Dinjens, Annick Haesevoets, Martina Rudelius, Erik Thunnissen, Marco Volante, Wim Van Criekinge, Manon van Engeland, Frans C.S. Ramaeke
Clinical Cancer Research.2013; 19(8): 2197. CrossRef
Altered expression of microRNA miR‐21, miR‐155, and let‐7a and their roles in pulmonary neuroendocrine tumors
Hyoun Wook Lee, Eun Hee Lee, Seung Yeon Ha, Chang Hun Lee, Hee Kyung Chang, Sunhee Chang, Kun Young Kwon, Il Seon Hwang, Mee Sook Roh, Jeong Wook Seo
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Differential expression of forkhead box M1 and its downstream cyclin‐dependent kinase inhibitors p27kip1 and p21waf1/cip1 in the diagnosis of pulmonary neuroendocrine tumours
Seung Yeon Ha, Chang Hun Lee, Hee Kyung Chang, Sunhee Chang, Kun Young Kwon, Eun Hee Lee, Mee Sook Roh, Boram Seo
Histopathology.2012; 60(5): 731. CrossRef

Case Reports

Carcinoid Tumor Arising in a Horseshoe Kidney: A case report.: Yoo Jin Kim, Bang Hur, Man Ha Hur; Korean J Pathol. 1996;30(12):1129-1137.

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Abstract PDF: Primary carcinoid tumor of the kidney is extremely rare ; only 29 previous reports have been described in the world literature, 3 cases of which were known to arise in horseshoe kidneys. Because of the scarcity of primary renal carcinoid tumor, its clinicopathologic features and prognosis are not well characterized, and its histogenesis is unknown. We present a case of primary carcinoid tumor arising in the horseshoe kidney of a 43-year-old man. The lesion is morphologically identical to those of gastrointestinal or respiratory tracts. In addition, this tumor contains clusters of intestinal epithelium with goblet cells and mature bony trabeculae. The cytoplasm of the tumor cells are immunoreactive for keratin, NSE, and synaptophysin, but are negative with Grimelius and Fontana-Masson stains. Membrane-bound cytoplasmic neurosecretory granules are observed by electron microscopic examination. This is the first case of primary renal carcinoid tumor arising in a horseshoe kidney documented in Korea. We describe the gross features, light and electron microscopic, and immunohistochemical findings of renal carcinoid and review the literature, with speculations on the possible histogenesis of this unusual neoplasm.

Calcitonin Producing Middle Ear Carcinoid with Amyloid Deposition: A Case Report.: Beom Jin Lim, Woo Ick Yang, Soon Won Hong, Chanil Park; Korean J Pathol. 2002;36(2):115-118.

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Abstract PDF: Carcinoid tumor of the middle ear cavity is a rare neoplasm of low malignant potential. It grows slowly and rarely metastasizes. We recently experienced a case of carcinoid tumor of the middle ear cavity occurring in a 51-year-old female who was presented with hearing loss and tinnitus of the right ear. A 1 cm sized pinkish soft mass was noted in the promontory of the middle ear. Histologically, the mass was composed of nests and cords of tumor cells with slightly pleomorphic nuclei and eosinophilic cytoplasm. The extracellular matrix was glassy pink, homogeneous and exhibited apple green birefringence under a polarized light microscope after Congo red staining. The tumor cells showed immunoreactivity for cytokeratin, chromogranin A, synaptophysin, neuron-specific enolase and calcitonin. Electron microscopic examination confirmed the presence of neurosecretory granules. The production of calcitonin and amyloid by the tumor cells suggests the possible relationship of this tumor to the thyroid C cells.

Fine Needle Aspiration Cytology of Atypical Carcinoid Tumor of the Lung: 2 Cases Report .: Youn Soo Lee, Gyeong Sin Park, Young Jin Choi, Seok Jin Kang, Byung Kee Kim, Sang In Shim; Korean J Cytopathol. 1997;8(1):76-82.

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Abstract PDF: Two cases of pulmonary atypical carcinoid tumor were diagnosed by fine needle aspiration cytology. Although the cytologic features of atypical carcinoid tumor have been relatively well described, it is easy to confuse atypical carcinoid tumor with typical carcinoid tumor, small cell carcinoma and adenocarcinoma of the lung. Atypical carcinoid tumor has been recognized as a distinct variant of pulmonary neuroendocrine carcinoma, with characteristic histopathologic and clinical features that separate it from both carcinoid and small cell carcinoma. The distinction of atypical carcinoid tumor from small cell carcinoma has important prognostic and therapeutic implications. The cytologic characteristics of atypical carcinoid tumor included polygonal to fusiform cells with a variable amount of lacy cytoplasm, oval nuclei with coarsely dispersed chromatin and frequent nucleoli, and mild pleomorphism. The malignant cells were arranged either in acinus-like clusters or in epithelial sheets.

Fine Needle Aspiration Cytology of a Thymic Carcinoid Tumor: A Case Report.: Young Ha Oh, Ki Seok Jang, Young Soo Song, Chul Burm Lee, Choong Ki Park, Moon Hyang Park, Yong Wook Park; Korean J Cytopathol. 2005;16(1):41-46.

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Abstract PDF: Carcinoid tumors of the thymus are vanishingly rare, and the characteristic cytologic findings of this condition have never before been reported in Korea. Recently, we encountered a 58-year-old woman who had been suffering from general weakness and weight loss for several months. Radiological imaging revealed a large anterior mediastinal mass. A fine needle aspiration biopsy (FNAB) of the mass showed predominantly scattered single cells, as well as some loose clusters of small cells with scanty cytoplasm. Some of these small cells exhibited plasmacytoid features, with moderately granular cytoplasm. We also discuss the cytological differential diagnosis between thymic carcinoid and other mediastinal tumors.

Original Article

The Clinicopathological Characteristics of Gastrointestinal Neuroendocrine Tumors; An Analysis of 65 Cases.: Hyunjoo Lee, Jungwoo Choi, Jung Suk An, Hyunchul Kim, Bong Kyung Shin, Aeree Kim, Hankyeom Kim, Insun Kim; Korean J Pathol. 2007;41(3):149-157.

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Abstract PDF: Background
: This study was designed to investigate gastrointestinal neuroendocrine tumors with an emphasis on their clinicopathological characteristics.
Methods
: Sixty-five cases were reviewed and classified as typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SmCC). We performed immunohistochemistry to characterize the expression of the immunoreactivity for synaptophysin, chromogranin, gastrin, somatostatin, thyroid transcription factor-1, p53 and Ki-67.
Results
: Most commonly, the tumors were located in the rectum (54%), followed by the stomach (23%) and colon (9%). Histologically, the tumors were classified as 49 TCs, 4 ACs, 6 LCNECs and 6 SmCCs. Most tumors were stained positive for synaptophysin and/or chromogranin. Four LCNECs and one SmCC were p53-positive. The carcinoids revealed a low level (<5%) of reactivity for Ki-67, while > or =30% of the cells showed reactivity for Ki-67 in the majority of LCNECs and SmCCs. Six patients with metastatic carcinoids were older than those patients without metastasis (64 vs 48 years, respectively, p=0.004). Furthermore, the size of tumors was larger for the patients with metastatic carcinoids than for the patients with nonmetastatic carcinoids (2.3 vs 0.5 cm, respectively, p=0.005).
Conclusion
: Old age, large tumor size and muscle invasion are associated with high grade neuroendocrine tumor and lymph node metastasis for those patients with carcinoids.

Case Report

Primary Carcinoid Tumor of the Uterine Corpus: A Case Report.: Sung Ran Hong, Hy Sook Kim, Jae Uk Shim; Korean J Pathol. 2004;38(2):109-112.

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Abstract PDF: Carcinoid tumors of the female genital tract are an uncommon clinical finding. This study presents a case of typical carcinoid tumor of the uterine corpus in a 61-year-old woman. The tumor was a primary carcinoid tumor arising from the endometrium which showed the typical organoid patterns with a positive reaction for neuroendocrine markers. The patient was treated by a total hysterectomy and bilateral salpingo-oophorectomy. No evidence for the carcinoid syndrome was noted. The carcinoid tumor recurred as a vaginal mass approximately six and a half years later. The patient died from a mechanical intestinal obstruction by the carcinoid tumor with distant metastasis approximately eight and a half years after operation of the endometrial primary tumor.

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