An endobronchial tumor, resected from a 77‐year‐old man, had an endometrioid histologic pattern consistent with fetal adenocarcinoma. A distinctive feature of the neoplasm was prominent neuroendocrine differentiation, including single, discrete neuroendocrine cells; aggregates of neuroendocrine cells resembling miniature carcinoid tumors; and a single focus of undifferentiated small cell carcinoma. Immunohistochemical staining of neuroendocrine cells revealed the presence of neuronspecific enolase, chromogranin, somatostatin, insulin, and serotonin. The heterogeneous cell populations caused problems in differential diagnosis and histologic classification. This case demonstrates that fetal adenocarcinoma may occur as a central endobronchial mass and express a variable degree of neuroendocrine differentiation. Cancer 1994; 73:1383–9.
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