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Carcinoid Tumor

Etiology: • Unknown.

Pathogenesis: • Neoplasms exhibit features of Kulchitsky cells.

Epidemiology: • Extremely uncommon. • More frequent in young patients <40 years. • Unrelated to cigarette smoking

General Gross Description: • Polypoid tan mass protruding into the lumen of a major bronchus • Cut surfaces are yellow • Distal obstructive pneumonia may be profound with dilated mucous filled airways and consolidated firm parenchyma • Atypical carcinoids tend to occur on the periphery of the lung.

General Microscopic Description: • Typical or mature carcinoids are composed of cells arranged in cords, nests or trabeculae • Richly vascularized • Nuclei are round, regular, with delicate chromatin pattern and inconspicuous nucleoli • Stain with antibodies to neuron specific-enolase and chromogranin

Clinical Correlations: • Cough with hemoptysis • Systemic symptoms of distal pneumonia including fever, malaise, sweats etc • Low grade neoplasms may metastasize to adjacent nodes • Many respond to removal of affected bronchus and lung • Alternative management can include laser ablation of the neoplasm • Atypical carcinoids are considered low grade malignancies. • Most malignant end of neuroendocrine neoplasm group is small cell carcinoma.

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders. Philadelphia 1994. pp. 726-727. • Dail DH, Hammar SP. Pulmonary Pathology. 2nd edition. Springer-Verlag. New York 1994. pp. 1207-1221.