Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features

Cesar A. Moran; Kaleigh E. Lindholm; Hans Brunnström; Gerald Langman; Se Jin Jang; Dominic Spagnolo; Siaw Ming Chai; Andrew Laycock; Giovanni Falconieri; Stefano Pizzolitto; Alessandro de Pellegrin; Filomena Medeiros; Lilian Edmunds; Ana Catarino; Fernando Cunha; Jae Ro; Sergio Pina-Oviedo; Jose Torrealba; Domenico Coppola; Fredrik Petersson; Ming Lian Oon; Goran Elmberger; Santiago Ramon y Cajal; Irene Sansano Valero; Liliana Dalurzo; Fernando Soares; Antonio H. Campos; Semir Vranic; Faruk Skenderi; Arlene M. Correa; Boris Sepesi; David Rice; Reza Mehran; Garrett Walsh

doi:10.1016/j.humpath.2020.02.005

Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features

Cesar A. Moran, Kaleigh E. Lindholm, Hans Brunnström, Gerald Langman, Se Jin Jang, Dominic Spagnolo, Siaw Ming Chai, Andrew Laycock, Giovanni Falconieri, Stefano Pizzolitto, Alessandro de Pellegrin, Filomena Medeiros, Lilian Edmunds, Ana Catarino, Fernando Cunha, Jae Ro, Sergio Pina-Oviedo, Jose Torrealba, Domenico Coppola, Fredrik PeterssonMing Lian Oon, Goran Elmberger, Santiago Ramon y Cajal, Irene Sansano Valero, Liliana Dalurzo, Fernando Soares, Antonio H. Campos, Semir Vranic, Faruk Skenderi, Arlene M. Correa, Boris Sepesi, David Rice, Reza Mehran, Garrett Walsh

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6 Scopus citations

Abstract

We present 783 surgical resections of typical and atypical carcinoid tumors of the lung identified in the pathology files of 20 different pathology departments. All cases were critically reviewed for clinical and pathological features and further correlated with clinical outcomes. Long-term follow-up was obtained in all the patients and statistically analyzed to determine significance of the different parameters evaluated. Of the histopathological features analyzed, the presence of mitotic activity of 4 mitoses or more per 2 mm², necrosis, lymphatic invasion, and lymph node metastasis were identified as statistically significant. Tumors measuring 3 cm or more were also identified as statistically significant and correlated with clinical outcomes. Based on our analysis, we consider that the separation of low- and intermediate-grade neuroendocrine neoplasms of the lung needs to be readjusted in terms of mitotic count as the risk of overgrading these neoplasms exceeds 10% under the current criteria. We also consider that tumor size is an important feature to be considered in the assessment of these neoplasms and together with the histological grade of the tumor offers important features that can be correlated with clinical outcomes.

Original language	English (US)
Pages (from-to)	98-109
Number of pages	12
Journal	Human Pathology
Volume	98
DOIs	https://doi.org/10.1016/j.humpath.2020.02.005
State	Published - Apr 2020

Keywords

Atypical carcinoid
Carcinoid
Intermediate grade
Low grade
Lung
Neuroendocrine

ASJC Scopus subject areas

Pathology and Forensic Medicine

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10.1016/j.humpath.2020.02.005

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Moran, C. A., Lindholm, K. E., Brunnström, H., Langman, G., Jang, S. J., Spagnolo, D., Chai, S. M., Laycock, A., Falconieri, G., Pizzolitto, S., de Pellegrin, A., Medeiros, F., Edmunds, L., Catarino, A., Cunha, F., Ro, J., Pina-Oviedo, S., Torrealba, J., Coppola, D., ... Walsh, G. (2020). Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features. Human Pathology, 98, 98-109. https://doi.org/10.1016/j.humpath.2020.02.005

Moran, CA, Lindholm, KE, Brunnström, H, Langman, G, Jang, SJ, Spagnolo, D, Chai, SM, Laycock, A, Falconieri, G, Pizzolitto, S, de Pellegrin, A, Medeiros, F, Edmunds, L, Catarino, A, Cunha, F, Ro, J, Pina-Oviedo, S, Torrealba, J, Coppola, D, Petersson, F, Oon, ML, Elmberger, G, y Cajal, SR, Valero, IS, Dalurzo, L, Soares, F, Campos, AH, Vranic, S, Skenderi, F, Correa, AM, Sepesi, B, Rice, D, Mehran, R & Walsh, G 2020, 'Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features', Human Pathology, vol. 98, pp. 98-109. https://doi.org/10.1016/j.humpath.2020.02.005

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title = "Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features",

abstract = "We present 783 surgical resections of typical and atypical carcinoid tumors of the lung identified in the pathology files of 20 different pathology departments. All cases were critically reviewed for clinical and pathological features and further correlated with clinical outcomes. Long-term follow-up was obtained in all the patients and statistically analyzed to determine significance of the different parameters evaluated. Of the histopathological features analyzed, the presence of mitotic activity of 4 mitoses or more per 2 mm2, necrosis, lymphatic invasion, and lymph node metastasis were identified as statistically significant. Tumors measuring 3 cm or more were also identified as statistically significant and correlated with clinical outcomes. Based on our analysis, we consider that the separation of low- and intermediate-grade neuroendocrine neoplasms of the lung needs to be readjusted in terms of mitotic count as the risk of overgrading these neoplasms exceeds 10% under the current criteria. We also consider that tumor size is an important feature to be considered in the assessment of these neoplasms and together with the histological grade of the tumor offers important features that can be correlated with clinical outcomes.",

keywords = "Atypical carcinoid, Carcinoid, Intermediate grade, Low grade, Lung, Neuroendocrine",

author = "Moran, {Cesar A.} and Lindholm, {Kaleigh E.} and Hans Brunnstr{\"o}m and Gerald Langman and Jang, {Se Jin} and Dominic Spagnolo and Chai, {Siaw Ming} and Andrew Laycock and Giovanni Falconieri and Stefano Pizzolitto and {de Pellegrin}, Alessandro and Filomena Medeiros and Lilian Edmunds and Ana Catarino and Fernando Cunha and Jae Ro and Sergio Pina-Oviedo and Jose Torrealba and Domenico Coppola and Fredrik Petersson and Oon, {Ming Lian} and Goran Elmberger and {y Cajal}, {Santiago Ramon} and Valero, {Irene Sansano} and Liliana Dalurzo and Fernando Soares and Campos, {Antonio H.} and Semir Vranic and Faruk Skenderi and Correa, {Arlene M.} and Boris Sepesi and David Rice and Reza Mehran and Garrett Walsh",

note = "Publisher Copyright: {\textcopyright} 2020",

year = "2020",

month = apr,

doi = "10.1016/j.humpath.2020.02.005",

language = "English (US)",

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pages = "98--109",

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T1 - Typical and atypical carcinoid tumors of the lung

T2 - a clinicopathological correlation of 783 cases with emphasis on histological features

AU - Moran, Cesar A.

AU - Lindholm, Kaleigh E.

AU - Brunnström, Hans

AU - Langman, Gerald

AU - Jang, Se Jin

AU - Spagnolo, Dominic

AU - Chai, Siaw Ming

AU - Laycock, Andrew

AU - Falconieri, Giovanni

AU - Pizzolitto, Stefano

AU - de Pellegrin, Alessandro

AU - Medeiros, Filomena

AU - Edmunds, Lilian

AU - Catarino, Ana

AU - Cunha, Fernando

AU - Ro, Jae

AU - Pina-Oviedo, Sergio

AU - Torrealba, Jose

AU - Coppola, Domenico

AU - Petersson, Fredrik

AU - Oon, Ming Lian

AU - Elmberger, Goran

AU - y Cajal, Santiago Ramon

AU - Valero, Irene Sansano

AU - Dalurzo, Liliana

AU - Soares, Fernando

AU - Campos, Antonio H.

AU - Vranic, Semir

AU - Skenderi, Faruk

AU - Correa, Arlene M.

AU - Sepesi, Boris

AU - Rice, David

AU - Mehran, Reza

AU - Walsh, Garrett

PY - 2020/4

Y1 - 2020/4

N2 - We present 783 surgical resections of typical and atypical carcinoid tumors of the lung identified in the pathology files of 20 different pathology departments. All cases were critically reviewed for clinical and pathological features and further correlated with clinical outcomes. Long-term follow-up was obtained in all the patients and statistically analyzed to determine significance of the different parameters evaluated. Of the histopathological features analyzed, the presence of mitotic activity of 4 mitoses or more per 2 mm2, necrosis, lymphatic invasion, and lymph node metastasis were identified as statistically significant. Tumors measuring 3 cm or more were also identified as statistically significant and correlated with clinical outcomes. Based on our analysis, we consider that the separation of low- and intermediate-grade neuroendocrine neoplasms of the lung needs to be readjusted in terms of mitotic count as the risk of overgrading these neoplasms exceeds 10% under the current criteria. We also consider that tumor size is an important feature to be considered in the assessment of these neoplasms and together with the histological grade of the tumor offers important features that can be correlated with clinical outcomes.

AB - We present 783 surgical resections of typical and atypical carcinoid tumors of the lung identified in the pathology files of 20 different pathology departments. All cases were critically reviewed for clinical and pathological features and further correlated with clinical outcomes. Long-term follow-up was obtained in all the patients and statistically analyzed to determine significance of the different parameters evaluated. Of the histopathological features analyzed, the presence of mitotic activity of 4 mitoses or more per 2 mm2, necrosis, lymphatic invasion, and lymph node metastasis were identified as statistically significant. Tumors measuring 3 cm or more were also identified as statistically significant and correlated with clinical outcomes. Based on our analysis, we consider that the separation of low- and intermediate-grade neuroendocrine neoplasms of the lung needs to be readjusted in terms of mitotic count as the risk of overgrading these neoplasms exceeds 10% under the current criteria. We also consider that tumor size is an important feature to be considered in the assessment of these neoplasms and together with the histological grade of the tumor offers important features that can be correlated with clinical outcomes.

KW - Atypical carcinoid

KW - Carcinoid

KW - Intermediate grade

KW - Low grade

KW - Lung

KW - Neuroendocrine

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DO - 10.1016/j.humpath.2020.02.005

M3 - Article

C2 - 32145220

AN - SCOPUS:85082724549

SN - 0046-8177

VL - 98

SP - 98

EP - 109

JO - Human Pathology

JF - Human Pathology

ER -

Typical and atypical carcinoid tumors of the lung: a clinicopathological correlation of 783 cases with emphasis on histological features

Abstract

Keywords

ASJC Scopus subject areas

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