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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 819-825, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
WH Warren, VE Gould, LP Faber, CF Kittle and VA Memoli
Eighty-one primary pulmonary neuroendocrine neoplasms were assessed by the
classification of Gould and associates. The neuroendocrine features of
these tumors were studied by a combination of conventional light
microscopy, electron microscopy, and immunohistochemical staining for
hormonal substances and neuron-specific enolase. In each case, clinical
follow-up was obtained to test the prognostic value of this new
pathological classification. This study indicated that bronchial carcinoids
are very low-grade neuroendocrine neoplasms that are locally invasive and
only occasionally metastasize late in their course. Well- differentiated
neuroendocrine carcinomas are relatively low-grade carcinomas that either
present with or subsequently develop nodal or distant metastases in 73% of
patients. Intermediate cell neuroendocrine carcinomas are highly aggressive
tumors often mistakenly called "large cell undifferentiated carcinoma."
Their clinical course is comparable to that of small cell neuroendocrine
carcinomas, which has a mean survival of 9 months. The different clinical
courses of these tumors demonstrate the predictive value of the proposed
classification. It appears particularly valuable to identify
well-differentiated neuroendocrine carcinoma as a low-grade carcinoma,
distinct from true bronchial carcinoids. This classification may resolve
some discrepancies regarding the therapy for and prognosis of "carcinoids"
and their presumed variants.
ARTICLES
Neuroendocrine neoplasms of the bronchopulmonary tract. A classification of the spectrum of carcinoid to small cell carcinoma and intervening variants
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