Typical carcinoid and atypical carcinoid in the differential diagnosis

By | March 27, 2012

Typical carcinoid and atypical carcinoid in the differential diagnosis typical carcinoid (TC) and atypical carcinoid (AC): TC and AC in the identification mentioned above, combined with the clinical surgical specimens, the differential diagnosis is generally not difficult. If bronchoscopy or percutaneous lung through small specimens can be diagnosed as carcinoid, TC and AC do not have identification. Actually impossible.
Typical carcinoid and atypical carcinoid of the differential diagnosis of spindle cell carcinoid lung spindle cell tumors: spindle cell carcinoid of the lung is a rare type of carcinoid tumors. The cell morphology and spindle cell lung cancer similar, but the spindle cell carcinoid in the organizational structure showed varying degrees of structural features of neuroendocrine differentiation, can be distinguished from other spindle cell tumors of lung.
a. pulmonary leiomyoma or leiomyosarcoma: a larger cell volume, long-spindle, cytoplasm addicted, nuclear was rod-like, with small nucleoli. If the smooth muscle sarcoma cells, then obviously shaped. Differentiation and immunohistochemistry can help identify. Network fiber staining, showing carcinoid organs rich capillary network-like structure; picric acid – acid fuchsin staining eve staining, the color-positive smooth muscle, neuroendocrine markers, diffuse type cancer cells positive; myogenic, markers, flat diffuse tumor positive.
b. nerve Ju tumor (schwannoma): spindle-shaped tumor cells, even chromatin, nucleolus, obviously, and spindle cell carcinoid similar. However, the uneven distribution of neural John tumor cells, a cell pool and cell sparse areas, mucus changes associated with substrate; nucleus was Pvt type arrangement. This is different from any form of cell carcinoid tumor. Nerve tumor of the 5-100 protein and Han Ju marrow were positive for protein; spindle cell neuroendocrine carcinoid tumors were positive for antibody expression.
c. fibrous mesothelioma: cell morphology and spindle cell carcinoid similar. However, the main fibrous tumor is a tumor of the pleura, the lack of organ-like structure of tumor tissue; immunohistochemical double-contrast towel on the neuroendocrine markers were negative developed. These different from the spindle cell carcinoid tumor.
d. fibrosarcoma and spindle cell carcinoma: its cell atypia and malignant characteristics, different from the spindle cell carcinoid tumor.
Typical carcinoid and atypical carcinoid differential diagnosis of follicular oncocytic carcinoid tumors and carcinoid tumors (follicular carcinoid) with different metastatic carcinoma of thyroid: thyroid cancer, the clinical features of pulmonary metastasis: first, the existence of thyroid primary tumor, goiter large; Second, pulmonary lesions were multifocal, thyroglobulin immunohistochemistry positive. These different from the same type of lung carcinoid tumor.
Typical carcinoid and atypical carcinoid differential diagnosis of papillary carcinoid tumors (papillary carcinoid) and pulmonary sclerosing hemangioma and papillary adenocarcinoma of the lung Identification: lung carcinoid tumors, and sometimes are seen in papillary carcinoma cells were arranged; lung sclerosing hemangioma, alveolar epithelial hyperplasia can be E-type was papillary, the two are similar in structure. But the papillary carcinoid, shaft is thin-walled capillaries cardiovascular, more single tumor; and pulmonary sclerosing hemangioma, hyperplasia of alveolar epithelial type E coating is a thick-walled blood vessels with blood vessels become transparent, in addition, there are into a piece of tissue-like cells and foam cells. Immunohistochemistry: Papillary carcinoid tumor of the neuroendocrine markers were positive for antibodies, and pulmonary sclerosing hemangioma of the labeled antibody on the cell, such as the AAT, AACT, and lysozyme, were positive.

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