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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neuroendocrine lung tumors such as typical carcinoid, atypical carcinoid, small-cell lung carcinoma, and large-cell neuroendocrine carcinoma represent a variable group with different biologic characteristics and unclear genetical relationships. We investigated the pattern of allelic loss on chromosome arm 11q in 20 sporadic carcinoid tumors of the lung using 10 microsatellite markers. Loss of heterozygosity was found in 13 of 20 tumors. In 5 of 9 typical carcinoids, 3 distinct regions of allelic loss were identified: 11q13.1 (D11S1883), 11q14.3-11q21 (D11S906), and 11q25 (D11S910). Atypical carcinoids showed loss of heterozygosity at 4 different regions: the first, most proximal region at 11q13 between markers PYGM and D11S937; the second at 11q14.3-11q21 (D11S906); and the third and fourth defined by markers D11S939 (11q23.2-23.3) and D11S910 (11q25). However, the region 11q13 harboring the MEN1 gene was more frequently affected in atypical carcinoids (7 of 11) than in typical carcinoids (2 of 9). The high rate of allelic losses within chromosomal region 11q13 in atypical carcinoids emphasizes the importance of this region for tumor development. We also recognized that more aggressive atypical carcinoids defined by high mitotic counts, vascular invasion, and/or organ metastasis are combined with increased allelic losses. HUM PATHOL 32:333-338.
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PMID:Loss of heterozygosity on chromosome arm 11q in lung carcinoids. 1127 44

The ability to fuse (or merge) data sets from SPECT and coincidence nuclear medicine scans with computed tomographic images combines physiologic information from the former method with the superior anatomic resolution of the latter technique. In many cases, this allows more definitive diagnosis than can be obtained by simple visual comparison of nuclear medicine images and conventional cross-sectional imaging. The technique may be used in the staging and follow-up of lung carcinoma, pulmonary carcinoid, and lymphoma. It may also aid in the interpretation of perfusion defects in Tc-99m MAA lung scanning, aid in the interpretation of ground-glass opacity in selected cases of chest high-resolution computed tomography, and aid in the diagnosis of some mediastinal masses (e.g., intrathoracic goiters). In this nuclear medicine atlas, the method used to create fusion images in the chest is described, and examples of fusion imaging with radiopharmaceuticals are given that may be of clinical use in chest disease.
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PMID:Potential uses of computed tomography-SPECT and computed tomography-coincidence fusion images of the chest. 1131 24

The group of small cell tumors of the lung includes fine following: (1) small cell carcinoma (SCC) of neuroendocrine (NE) origin, (2) poorly differentiated squamous carcinoma, (3) the rare basaloid (basal cell) carcinomas, and (4) malignant lymphomas, primitive neuroectodermal tumors (PNETs), and rhabdomyosarcomas. The differential diagnosis among these entities carries a heavy therapeutic impact but may be difficult in small biopsy specimens or in cytologic material, especially if necrosis or artifactual alterations are present. The use of additional techniques such as immunostaining for NE markers is not always helpful, since immunoreactive chromogranin A is detectable in only a small percentage of small cell carcinomas. It has recently been reported that in the aerodigestive tract 34betaE12 cytokeratin (CK) immunostaining selectively labels non-NE carcinomas, including squamous cell carcinoma, adenocarcinoma, and the rare basaloid carcinoma. We evaluated the role of such CK immunodetection in the differential diagnosis of small cell lung tumors in cytologic and biopsy specimens. Eighty-one lung tumors diagnosed by means of endoscopic bronchial biopsy, fine needle aspirate, or bronchial washing were collected. They included 43 small cell NE carcinomas and 38 cases used as controls (comprehensive of 2 large cell neuroendocrine carcinomas, 4 carcinoid tumors, 30 cases of non-NE lung carcinomas, 2 cases of bronchial infiltration by non-Hodgkin lymphomas). 34betaE12 CK immunoreactivity was found in 29/30 cases of non-NE carcinomas, but in only 3/43 SCCs. The latter showed positivity in only a few scattered cells. The 2 cases of bronchial infiltration by malignant lymphoma as well as the 4 cases of carcinoid tumors and the 2 cases of large cell neuroendocrine carcinomas were negative. These findings were confirmed in the surgical specimens of operatedon cases. We conclude that, in lung carcinoma biopsies showing a small cell pattern, presence of 34betaE12 CK immunoreactivity favors a non-NE carcinoma, whereas its absence supports the diagnosis of SCC. Int J Surg Pathol 8(4):317-322, 2000
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PMID:34betaE12 Cytokeratin Immunodetection in the Differential Diagnosis of Small Cell Tumors of Lung. 1149 8

Kidney tumors represent a wide scale of histological observations. However, only angiomyolipoma can be recognised preoperatively from results of the graphical examination. Other types can be recognised only on the bases of histological examination. Completely benign tumor is oncocytoma (it represents about 5% of all kidney tumors). Angiomyolipoma (2%) is also benign, though some case reports describing its malign transformation has been published. Angiomyolipoma under 4 cm can be only monitored, the larger tumors should be resected or selectively embolised the arterial blood supply to prevent spontaneous rupture. From the group of benign tumors only cystic nephroma can be diagnosed more often (up to 1%). One of the criteria for diagnosing the renal cortical adenoma is its size under 5 mm. That is why any adenoma, which could be diagnosed by means of graphical examination and therefore clinically significant does not exist. Most of tumors are malign epithelial tumors--renal carcinomas (RC). The are classified according Heidelberg classification into 5 elementary types: clear cell, papillary, chromophobe, originating form collecting ducts and not classifiable. Clear cell (conventional) renal carcinoma (CRC) comes most often (70 to 80%), its malign potential rise with increased size of tumor and with the gradient. Five-year survival is achieved in 30-50%. Granular form of CRC carcinoma (7% of all CRC) is the equivalent of poorly differentiated PRC and it has an adverse prognosis. In contrary, the cystic form of CRC (about 6%) in benign. Papillary form of RC has the five-year survival in 84%, malignant are only tumors poorly differentiated. These are tumors with extensive necroses, which brings a fragile consistency and they can be distinguished by graphical examination. Chromophobe type of RC (5%) has the five-year survival in 90%. Poor prognosis has its sarcomatoid form, which can originate from any RC, but most frequently it is derived from the chromophobe type. The form originating from collecting ducts is highly infrequent and very malignant with the five-year survival in 20% only. The unclassified form of RC (3-5%) includes tumors not suiting to the criteria of the previous RC. Other primary renal malignant tumors (sarcomas, Wilms' tumor of adults, medullar carcinoma, carcinoid) are very rare. Comparatively frequent are metastases of other tumors (namely that of lung carcinoma) and renal impairment in leukemia, which are complication not often met by urologist.
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PMID:[Histologic classification of kidney tumors for clinical practice in adults]. 1150 85

Cushing syndrome (CS) caused by ectopic adrenocorticotropic hormone (ACTH) production (EA) poses major challenges diagnostically by mimicking the pituitary-dependent form of CS and therapeutically by producing severe, life-threatening hypercortisolemia. This retrospective follow-up study describes the clinical characteristics and course of EA in a large referral center. Computer-based cross-index codes for EA, CS, and bilateral adrenalectomy were used to identify patients treated at the Mayo Clinic between 1956 and 1998. EA was confirmed in 106 patients. Gender distribution showed a slight female predominance (61:45). Bronchial carcinoid was the most frequent cause of EA (25%), followed by islet cell cancer (16%), small-cell lung carcinoma (11%), medullary thyroid cancer (8%), disseminated neuroendocrine tumor of unknown primary source (7%), thymic carcinoid (5%), pheochromocytoma (3%), disseminated gastrointestinal carcinoid (1%), and other tumors (8%). No tumor was found in 16% of patients. Altogether, 28 patients were managed medically, and the others underwent curative tumor resection (13 patients) or bilateral adrenalectomy (65 patients). Surgically treated patients had longer survival, but this was most likely affected by treatment bias. The diagnoses of CS and ACTH-secreting neoplasm were usually concurrent, although, there were remarkable cases in which the two conditions were diagnosed several years apart. Curative resection of the tumor producing EA was possible in a small proportion of patients (12%). When curative resection is not possible, patients who are reasonable surgical candidates are likely to benefit from adrenalectomy. Additional experience with bilateral laparoscopic adrenalectomy should increase the number of patients who benefit from adrenal-directed surgery.
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PMID:Cushing syndrome due to ectopic adrenocorticotropic hormone secretion. 1157 35

Pulmonary neuroendocrine cells are scant and widespread within the pulmonary epithelium. The function they play is not fully known, more studies are needed to clearly define it. They have been implicated however, as either the culprit or victim of many pulmonary diseases. That is the reason, why so many scientists take interest in the pulmonary neuroendocrine system. This paper reviews current information regarding pulmonary neuroendocrine cells, their origin, morphology, ontogeny, role, neuroendocrine cell markers, dysplasia and hyperplasia of pulmonary neuroendocrine cells in various conditions, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, typical carcinoid, atypical carcinoid, small-cell lung carcinoma, large-cell neuroendocrine carcinoma and the unusual spectrum of pulmonary neuroendocrine tumours.
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PMID:Pulmonary neuroendocrine cells in physiology and pathology. 1182 Jun 29

The pathogenesis and interrelationships of neuroendocrine lung carcinomas are not well understood. Tissue macro-arrays prepared from surgical resection specimens from 35 patients with typical carcinoid (TC), six with atypical carcinoid (AC), 13 with large cell neuroendocrine carcinoma (LCNEC), and 15 with small cell lung carcinoma (SCLC) were investigated by fluorescence in situ hybridization (FISH) and immunohistochemistry. Hybridizations with locus-specific DNA probes demonstrated a high incidence of deletion for the tumour suppressor genes p53 and retinoblastoma (Rb), and for the oncogene cyclin D1, comparable in all carcinoma types. Similarly, an increase of DNA copy number for the Her-2/neu and c-myc oncogenes was noted in all neoplasms. A more detailed quantitative analysis of the results, however, demonstrated increasing numbers of cells harbouring these genomic alterations, from low-grade TC to highly malignant SCLC, with the exception of cyclin D1 deletion. Mutations of the p53 and Rb genes, as assayed by immunohistochemical studies, were observed at high incidence in high-grade carcinomas, compared with a low incidence in the low-grade carcinomas. Conversely, in all carcinoma types, neither membrane-bound Her-2/neu nor nuclear cyclin D1 was detected. It is concluded that structural genomic alterations are frequent in neuroendocrine lung carcinomas and that their occurrence may be underestimated by immunohistochemical studies alone. The quantitative expansion of the Rb, p53, c-myc, and Her-2/neu alterations towards high-grade carcinomas suggests common pathogenetic mechanisms in the spectrum of these neoplasms.
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PMID:Quantitative expansion of structural genomic alterations in the spectrum of neuroendocrine lung carcinomas. 1192 Jul 36

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

In 1994 a 19-year-old woman presented with a few weeks history of back ache. Routine chest X-ray and CT examination revealed a lesion originating from the parietal pleura and destroying the ribs. The tumour was resected during thoracotomy. The histological examination raised the possibility of atypical carcinoid tumour. One year later the tumour recurred. After its re-resection, the patient received radiotherapy. Three years after the initial presentation multiple pulmonary metastases developed. The patient was treated with chemotherapy, receiving vincristine, epi-adriamycin and cyclophosphamide in 8 cycles, which resulted in complete remission. Between 1998 and 1999 progressions and partial remissions were observed, while the patient received further cycles of chemotherapy. Histological revision was performed in 1999 and a final diagnosis of desmoplastic small round cell tumour of the pleura was made. Immunohistochemically co-expression of cytokeratin, vimentin, desmin, and NSE was observed. The patient died in June 2000. The whole follow-up period was 76 months. We thought this case to be worth for presentation because this unusual long survival, which was probably due to the aggressive complex anticancer treatment.
Lung Cancer 2002 Jun
PMID:Desmoplastic small round cell tumour of the pleura: a case report with unusual follow-up. 1200 47

Pulmonary neuroendocrine tumors are currently considered to consist of three grades of malignancy, ranging from typical and atypical carcinoids to large-cell neuroendocrine carcinoma and small-cell carcinoma. The study reported here is the first population-based study of the demographics of patients with neuroendocrine tumors grouped by histological subtype. A cancer registry-based analysis of patients in Denmark in whom bronchial neuroendocrine tumor was diagnosed in 1978-97 was performed and the patients were followed up to 31 December 1999. Typical carcinoid was diagnosed in 105 patients, atypical carcinoid in 192, large-cell neuroendocrine carcinoma in 50 and small-cell carcinoma in 11,998. The recorded incidence of neuroendocrine tumors other than small-cell carcinoma increased by twofold among men (from 0.24 to 0.53 per 100,000 inhabitants per year) and by threefold in women (from 0.14 to 0.41 per 100,000 inhabitants per year) during the study period, while the incidence of small-cell carcinoma decreased among men and levelled off among women. The prognosis of patients with bronchial neuroendocrine tumors varied with the degree of malignancy; the 5-year survival rate ranged from 87% for patients with typical carcinoids, to 44, 15 and 2% for patients with atypical carcinoids, large-cell neuroendocrine carcinoma and small-cell carcinoma, respectively. In Denmark, the incidence of neuroendocrine tumours is increasing. Our findings support the pathological categorization of neuroendocrine tumors into three grades of malignancy. More research is needed to establish the etiological factors in the development of pulmonary neuroendocrine tumors.
Lung Cancer 2002 Aug
PMID:Pulmonary neuroendocrine tumors: incidence and prognosis of histological subtypes. A population-based study in Denmark. 1214 Jan 34


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