Clinicopathological characteristics and genetic analysis of pulmonary carcinoid tumors: A single‑center retrospective cohort study and literature review

Abstract

Pulmonary carcinoid tumors, including typical and atypical carcinoids, are well-differentiated neuroendocrine tumors (NETs) that represent 1-2% of all lung cancer cases. In the present study, all cases of well-differentiated NETs diagnosed at Tianjin Medical University General Hospital (Tianjin, China) between 2006 and 2016 were reviewed, and 20 pulmonary carcinoid cases were identified. The clinical features of these cases were summarized, and the results of pathological and imaging examinations were collated. As a low-grade malignant pulmonary neoplasm, the molecular biological mechanism of pulmonary carcinoids is yet to be elucidated. To investigate the underlying molecular mechanisms behind pulmonary carcinoids and to determine an effective molecular targeted therapeutic strategy, next-generation sequencing (NGS) was performed using tissue samples from six patients to determine additional molecular biological characteristics that may help guide targeted therapy. A total of 27 somatic mutations in 21 genes were detected. Of note, mutations in the KIT proto-oncogene receptor tyrosine kinase, Erb-B2 receptor tyrosine kinase 4, MET proto-oncogene receptor tyrosine kinase and insulin-like growth factor 1 genes occurred in two out of six cases. Since treatments for advanced carcinoids are relatively ineffective, molecular profiling may contribute to the identification of novel treatments. In addition, the literature on mutations in pulmonary carcinoids was reviewed and available clinical information and features of this tumor type were summarized.

Contribution of ¹⁸F-FDG PET/CT in the Differential Diagnosis of Pulmonary Hamartomas and Pulmonary Carcinoids

“…Pulmonary carcinoids are well-differentiated neuroendocrine carcinomas, originating from neuroendocrine cells called Kulchitzky, located in the bronchial or bronchiolar epithelium, comprising 1%-2% of all primary lung cancers ( 3 , 4 ). Pulmonary carcinoids and pulmonary hamartomas are often observed as well-circumscribed, lobulated, rounder oval lesions on computed tomography (CT) ( 1 , 5 ).…”

Clinic and genetic similarity assessments of atypical carcinoid, neuroendocrine neoplasm with atypical carcinoid morphology and elevated mitotic count and large cell neuroendocrine carcinoma

“…The WHO (4th edition) diagnostic criteria recommends the use of NE markers to confirm a diagnosis of neuroendocrine differentiation [ 1 ] the guidelines for the diagnosis and management of pNEN (2020) support this point [ 34 ], and this is reiterated in the 5th edition [ 13 ]. Our results suggest that compared with HE, IHC is more accurate in diagnosing lung carcinoids, in particular, Syn and CgA can be used to distinguish NET from NEC [ 35 ]. TTF-1, a putative regulator of neurogenesis expressed in pNEC at various sites [ 36 , 37 ] was found to be mostly positive in peripheral NETs.…”

Abnormal shadow on chest radiograph: a supra – or infradiaphragmatic finding?

“…A well-defined contour, considered to be rather a benign characteristic, do not exclude a malignant lesion (2). Round shape and smooth margins may be present in both hamartoma and carcinoid (3,4). However, the calcification pattern and a lack of bronchiectasis or distal parenchymal disease, correspond better with peripheral hamartoma.…”