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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carcinoid tumors are rare neoplasms which, by tradition, have been divided into foregut, midgut, and hindgut tumors. Although they share many features, they seem to have different molecular backgrounds. Foregut tumors very often show involvement of the MEN1 gene with deletions and mutations, whereas midgut carcinoids display genetic changes on chromosome 18. Hindgut tumors in general show rather low proliferation capacity, and transforming growth factor-alpha/epidermal growth factor receptor autocrine mechanism may play a role in the tumor development. Sometimes it might be a problem to delineate the location of the primary carcinoid tumor, but analyzing thyroid transcription factor-1 can be of help, because this factor is only expressed in foregut carcinoid and not in midgut or hindgut tumors. Chromogranin A is an important general tumor marker for all types of carcinoid tumors. Somatostatin receptor scintigraphy is a cornerstone in staging and localization of carcinoid tumors, but newer techniques such as positron emission tomography will challenge its position in the future. Although surgical cure is not obtainable, a more aggressive surgery has emerged during the last decade. Debulking and other cytoreductive procedures are quite common today. Somatostatin analogues have been the treatment of choice in symptomatic patients with carcinoid tumors, but more recent studies have indicated a cytostatic effect of somatostatin analogues. Tumor-targeted radioactive treatment based on somatostatin analogues is now under clinical evaluation. Preliminary data indicate interesting clinical potentials.
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PMID:Carcinoid tumors: molecular genetics, tumor biology, and update of diagnosis and treatment. 1179 Sep 79

The World Health Organization's classification of lung tumors separately categorizes neuroendocrine (NE) lung tumors, small cell lung carcinoma (SCLC), and large cell neuroendocrine carcinoma (LCNEC) as high-grade NE malignancies and carcinoids (typical, [TC] and atypical [AC]) as low- and intermediate-grade malignancies. Although these NE tumors are considered with NE hyperplasia (NEH) and tumorlets as part of a spectrum of NE proliferations, their derivation from a common progenitor cell has not received full agreement. With the aim of refining their differential diagnosis and extending our understanding of their histogenesis, we studied the expression of thyroid transcription factor-1 (TTF-1), a transcription factor that regulates lung morphogenesis and differentiation, along the spectrum of NE lung tumors. Two hundred and twenty- seven NE proliferations and tumors were immunostained with TTF-1 antibody. Positive immunostaining for TTF-1 was detected in 47 of 55 (85.5%) pure SCLCs, in 31 of 64 (49%) pure LCNECs, but in none of 15 NEHs, 23 tumorlets, or 50 carcinoid tumors (27 TCs and 23 ACs). In 19 of 20 (95%) combined SCLCs and LCNECs, TTF-1 expression was identical in both NE and non-NE components. These results show that TTF-1 is not expressed in normal and hyperplastic NE cells or in carcinoids, but is expressed in high-grade NE proliferations and in lung adenocarcinomas. This challenges the concept of a spectrum of NE proliferations and tumors and lends credence to the alternative hypothesis of a common derivation for SCLC and non-SCLC including LCNEC, with carcinoids deriving from a different stem cell.
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PMID:Expression of thyroid transcription factor-1 in the spectrum of neuroendocrine cell lung proliferations with special interest in carcinoids. 1195 42

Strumal carcinoid is an ovarian teratoma composed of thyroid tissue and carcinoid, intimately admixed in variable proportions. To further elucidate the histogenesis of strumal carcinoid, the expression pattern of thyroid transcription factor-1 (TTF-1) was evaluated in two cases of strumal carcinoid using immunohistochemical techniques. TTF-1 is a nuclear transcription protein that is selectively expressed in the thyroid and respiratory epithelium, and is thought to be expressed specifically in pulmonary and thyroid neoplasms. While the follicular lining cells of the strumal carcinoid showed positive staining for TTF-1, the carcinoid element was, for the most part, negative. These results confirm that TTF-1 is expressed in the thyroidal element of ovarian teratomas and also provide further evidence that the carcinoid component of the strumal carcinoid bears no relation to thyroidal differentiation.
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PMID:Expression of thyroid transcription factor-1 in strumal carcinoid and struma ovarii: an immunohistochemical study. 1216 4

We report two cases of a rare presentation of pulmonary sclerosing hemangioma as an endobronchial polyp resulting in clinical symptoms of bronchial obstruction. We describe the histological and cytological description of this entity based on material obtained during bronchoscopic examination. In both cases, bronchoscopy revealed a polypoid mass protruding into the left lower lobar bronchus, with a smooth and hemorrhagic surface, reminiscent of a carcinoid tumor. On bronchial washing in case 1, numerous small round cells were seen with uniform nuclei and inconspicuous nucleoli, arranged in clusters with a pavement-type pattern and papillary configuration. The presence of a few reactive pneumocytes gives a dual cell proliferation, in a background of numerous foamy macrophages. Although the four architectural patterns of sclerosing hemangioma were present in the resected tumors, the papillary and solid patterns predominated in the endobronchial component of the tumors and these were seen on the bronchial biopsies. Recognition of the papillary pattern, the typical round cells coexpressing thyroid transcription factor-1 and epithelial membrane antigen without cytokeratin immunoreactivity, are helpful clues for the diagnosis on bronchial biopsy. Finally, hopefully awareness by clinicians and pathologists that sclerosing hemangioma can present as an endobronchial mass will facilitate diagnosis when this rare event occurs.
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PMID:Endobronchial variant of sclerosing hemangioma of the lung: histological and cytological features on endobronchial material. 1470 17

Forkhead box A2 (Foxa2) is a winged helix nuclear transcription protein that regulates the expression of genes that are critical to lung morphogenesis, differentiation, and function, including thyroid transcription factor-1, surfactant proteins, and Clara cell secretory protein. We examined the immunoreactivity of Foxa2 in paraffin sections of 75 lung tumors: 17 typical carcinoids, 2 atypical carcinoids, 4 large cell neuroendocrine (NE) carcinomas, 23 small cell carcinomas, 19 adenocarcinomas, 7 squamous cell carcinomas, and 3 (non-NE) large cell carcinomas, using a polyclonal rabbit Foxa2 antibody and a biotin-streptavidin detection system. In the adjacent lung, Foxa2 was detected in normal and hyperplastic type II cells. Foxa2 immunoreactivity was detected in 13 typical carcinoids (76%), 2 atypical carcinoids (100%), 2 large cell NE carcinomas (50%), 11 small cell carcinomas (48%), and 1 adenocarcinoma (5%). Squamous cell carcinomas and (non-NE) large cell carcinomas uniformly lacked Foxa2 staining. Expression of Foxa2 in the entire spectrum of NE lung tumors is another indication of differentiation shared by typical carcinoid, atypical carcinoid, large cell NE carcinoma, and small cell carcinoma.
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PMID:Forkhead box A2 transcription factor is expressed in all types of neuroendocrine lung tumors. 1513 29

Carcinoids of different organs appear morphologically indistinguishable. We studied the usefulness of differential expression of CDX2 and thyroid transcription factor-1 (TTF-1) in 78 gastrointestinal and pulmonary carcinoids and their metastases (n = 10). CDX2 staining of gastric biopsy specimens with neuroendocrine hyperplasia (n = 11) and various gastritides (n = 10) was also performed. All ileal (6/6 [100%]), 6 (86%) of 7 appendiceal, 3 (75%) of 4 duodenal, 1 (50%) of 2 ampullary, 12 (33%) of 18 rectal, 6 (30%) of 20 pancreatic, and 1 (17%) of 6 gastric carcinoids expressed CDX2 with variable intensity; none of the pulmonary carcinoids stained. Of 15 pulmonary carcinoids, 8 (53%) stained with TTF-1, but none of the gastrointestinal carcinoids did. CDX2 and TTF-1 staining profiles of primary and metastatic carcinoids were similar. CDX2+ gastric endocrine cells had a distribution similar to that of gastrin and enterochromaffin cells but not enterochromaffin-like cells. Our results suggest that CDX2 and TTF-1 have high specificity for gastrointestinal and pulmonary carcinoids, respectively.
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PMID:Usefulness of CDX2 and TTF-1 in differentiating gastrointestinal from pulmonary carcinoids. 1571 36

Thirty-two cases of lung carcinoma metastatic to the ovary in women 26 to 76 years of age (mean, 47 years) are reported. A history of prior lung carcinoma was documented in 53% of cases (17 of 32), with the ovarian tumor detected at a mean interval of 1 year. In 10 cases (31%), the lung and ovarian tumors occurred synchronously, and in 5 (16%) the ovarian tumor was detected up to 26 months before the lung cancer. Small cell carcinoma was more likely to present with ovarian manifestations than other subtypes. A history of smoking was obtained in 9 cases (28%), but detailed histories were not always available and the figure may be spuriously low. Forty-four percent of the tumors were small cell carcinomas (14 of 32), 34% adenocarcinomas (11 of 32), and 16% large cell carcinomas (5 of 32); there was a single squamous cell carcinoma and one atypical carcinoid. Thirteen percent of cases (4 of 32) had a coexisting primary ovarian tumor. The mean ovarian tumor size was 9.7 cm, and one third of the ovarian metastases were bilateral. Tumor was limited to the lung and one or both ovaries in 13 cases (40%). Morphologic features common to many of the ovarian tumors were multinodular growth, widespread necrosis, and extensive lymphovascular invasion; involvement of the ovarian surface was rare. Attention to these features, to the usual absence of associated typical surface epithelial neoplasia, and to the clinical history enabled the correct diagnosis to be made in the majority of cases without need of special studies. In a minority of cases, immunohistochemical staining for thyroid transcription factor-1 was a useful ancillary marker in the distinction from primary ovarian carcinoma. The differential diagnosis with the primary ovarian tumors most often meriting consideration, including unusual variants of surface epithelial tumors, is discussed.
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PMID:Lung carcinoma metastatic to the ovary: a clinicopathologic study of 32 cases emphasizing their morphologic spectrum and problems in differential diagnosis. 1600 93

Histomorphologic features and routine endocrine immunohistochemical (IHC) markers do not differentiate neuroendocrine tumors (NETs) in relation to their location, making it difficult to establish the site of origin of a metastatic neoplasm. Site-specific markers would be useful, particularly when examining small biopsies. CDX-2 and thyroid transcription factor-1 (TTF-1) are transcription factors that have been recently proposed as IHC markers of intestinal and pulmonary adenocarcinomas, respectively. However, their expression in NETs has not been widely studied. The objective of this study is to evaluate the expression of TTF-1 and CDX-2 in NETs and their potential usefulness in distinguishing gastrointestinal and pulmonary NETs from other sites. We performed an IHC study on formalin-fixed, paraffin-embedded sections from 155 primary NETs, including 60 pulmonary, 60 gastrointestinal, 30 pancreatic, and 5 NETs from other sites. In addition, we evaluated 13 metastatic NETs, including 11 cases of gastrointestinal and 2 of pulmonary origin. In this study, CDX-2 was expressed in 28/60 (47%) of gastrointestinal NETs with the following results: 11/11 (100%) appendiceal, 12/14 (86%) small intestinal, 3/4 (75%) colonic, 2/11 (18%) rectal, and 0/20 (0%) gastric. TTF-1 was expressed in pulmonary carcinoid tumors in 13/30 (43%) and in 27/30 (90%) pulmonary small cell carcinomas. NETs of other origins (pancreas, skin, ovary, and thymus) were negative for both TTF-1 and CDX-2. Metastatic neuroendocrine neoplasms of intestinal origin were positive for CDX-2 and negative for TTF-1. In conclusion, CDX-2 expression is highly specific in identifying NETs of intestinal origin and TTF-1 expression is helpful in identifying NETs of pulmonary origin, which can be quite useful in the diagnosis of metastatic NETs of unknown origin.
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PMID:Diagnostic value of CDX-2 and TTF-1 expressions in separating metastatic neuroendocrine neoplasms of unknown origin. 1809 83

The objectives of this study were to evaluate the frequency of carcinoid tumors of the extrahepatic biliary ducts (EHBDs) and the pathologic progression and the role of surgery in the management of this disease. We describe two cases of malignant carcinoids of the EHBDs, which presented as common bile duct tumors in two adult male patients, aged 52 and 70 years, who were diagnosed histologically on surgical resection specimens. A comprehensive review of the literature has also been performed with a focus on survival data. Microscopically, the tumors presented herein were composed of relatively small rounded cells with a trabecular or nesting pattern. Both cases were diffusely immunopositive for chromogranin and synaptophysin, and one of them was also focally reactive with somatostatin and pancreatic polypeptide. There was no expression in any of these tumors of thyroid transcription factor-1 (TTF-1), gastrin, insulin, glucagon, vasoactive intestinal peptide (VIP) and prolactin. The tumor showed transmural invasion in both cases, with lymph node metastasis and subcapsular liver tissue infiltration in one. Both patients are alive with no evidence of disease 41 months and 59 months, respectively, after surgery. Despite being extremely uncommon, with only 70 cases reported to date, carcinoids should be included in the differential diagnosis of EHBD tumors. This study emphasizes the necessity of complete surgical resection as the gold standard treatment for these lesions, and the importance of a correct pathologic diagnosis for prognostic implications.
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PMID:Well-differentiated neuroendocrine carcinoma (malignant carcinoid) of the extrahepatic biliary tract: report of two cases and literature review. 2066 35

Primary renal carcinoid tumors are rare neoplasms. Because of the rarity of these neoplasms, clinicopathologic and immunohistochemical characteristics have not been fully characterized. Immunohistochemistry for renal cell lineage transcription factors, such as paired box gene 2 and paired box gene 8, has not been studied in renal carcinoid tumors and may be useful in demonstrating nephrogenic differentiation. We studied the clinical, morphological, and immunohistochemical features in 9 primary renal carcinoid tumors from multiple institutions with particular emphasis on immunohistochemical findings, in particular, expression of paired box gene 2 and paired box gene 8. All 9 cases expressed at least 1 neuroendocrine marker (CD56, synaptophysin, chromogranin). The renal-associated (paired box gene 2/paired box gene 8), gastrointestinal (caudal-related homeobox-2), and pulmonary/thyroid (thyroid transcription factor-1) transcription factors were not expressed in renal carcinoids (0/9). Of interest, CD99 was expressed in 8 of 9 cases, with the one negative case representing an atypical carcinoid. Perinephric extension and nodal and distant metastases are common. The absence of expression of paired box gene 2 and paired box gene 8, although not conclusive, supports the theory that these are derived from nonnephrogenic elements. CD99 was expressed in almost all cases (8/9); recognition of this could prevent misdiagnosis of a renal primitive neuroectodermal tumor.
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PMID:Primary renal carcinoid tumors: clinicopathologic features of 9 cases with emphasis on novel immunohistochemical findings. 2149 72


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