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September - December 2002: 
Volume 15, Issue 3

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ARCHIVE

Carcinoid tumors of the lung: A new approach based on histology
Abstract
Objective: Bronchial carcinoids are classified as pulmonary neuroendocrine neoplasms; the latter encompass a wide variety of tumors from typical carcinoid to small cell carcinoma. A retrospective analysis of 38 consecutive patients (22 male, 16 female, age range: 28 78 years) who had undergone resection surgery for bronchial carcinoid tumors in the period from 1988 to 1997, was performed. Material-methods: Tumor resection surgery procedures included lobectomy (25 patients), bronchoplasty (4 patients), pneumonectomy (3 patients) and wedge resection (6 patients). The histologic appearance of original tissue sections was re-assessed applying the up-dated classification criteria for neuroendocrine neoplasms proposed by Travis. Results: No peri-operative mortality was reported. Original histologic examination identified 28 typical and 10 atypical carcinoid tumors. Four cases of atypical carcinoid tumors were reclassified as large cell neuroendocrine carcinoma (LCNEC) and 2 cases of typical carcinoid tumors as atypical. Survival was significantly higher in patients with typical carcinoids compared to either LCNEC (P=.0008, Fischer’s exact) or atypical carcinoids (P=.027, Fischer’s exact). Only 4 patients (3 with atypical carcinoid, 1 with LCNEC) received adjuvant chemotherapy. Conclusion: The observed diversity in the behavior of pulmonary neuroendocrine neoplasms indicates the necessity of identifying the most virulent tumors and applying multi-modality regimens to such cases. Pneumon 2002, 15(3):286-290.