Combined larynx large cell neuroendocrine and squamous cell carcinoma: a case report

ABSTRACT Laryngeal cancer ranks third among the most common head and neck neoplasms. The most common histological subtype is squamous cell carcinoma, and neuroendocrine tumors are rare. An even rarer entity is a composite tumor with both these histologies. This case reports a metastatic combined carcinoma of squamous cells and large neuroendocrine cells, presenting favorable response to treatment with a total laryngectomy followed by adjuvant therapy including chemo-, radio-, and immunotherapy.

Primary endometrial large cell neuroendocrine carcinoma with melanocytic differentiation

High-grade endometrial carcinomas are aggressive neoplasms of difficult histological classification. Neuroendocrine differentiation in endometrial carcinomas is rare. This is the report of an endometrial large cell neuroendocrine carcinoma with foci of melanocytic differentiation in a 75-year-old woman with abnormal post-menopausal uterine bleeding for 2 years. Two initial biopsies were inconclusive. Histopathological examination of the uterus revealed large cell neuroendocrine carcinoma associated with endometrioid carcinoma and foci of melanocytic differentiation, pT3a (FIGO IIIA). There were metastases in the rectum serosa and lungs. After 8 months of diagnosis and surgical treatment, the patient is on chemotherapy and radiotherapy. We highlight the morphological characteristics and criteria that allow the definitive anatomopathological diagnosis, including immunohistochemical markers used to identify the cell types present in this unprecedented association.

Clinicopathologic features and genetic profile of the redefined large cell lung carcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic features and genetic profile of large cell lung carcinoma (LCC) redefined by new classification.@*Methods@#Basing on 2015 WHO classification criteria in redefining large cell lung carcinoma, the expression of specific markers (TTF1, Napsin A, p40, CK5/6, CK, vimentin and ZEB1) was detected by immunohistochemistry and D-PAS staining in 303 surgically-removed lung specimens previously diagnosed as large cell lung carcinoma. The clinicopathologic and genetic characteristics (including EGFR, KRAS, BRAF, ALK and ROS1 gene mutation) were analyzed.@*Results@#Based on the new definition of LCC, 116 cases (116/303, 38.3%) of LCC formerly diagnosed were reclassified as solid adenocarcinoma, 49 cases (49/303, 16.2%) as squamous cell carcinoma, 6 cases (6/303, 2.0%) as adenosquamous carcinoma, 22 cases (22/303, 7.3%) as spindle cell carcinoma and only 110 cases (110/303, 36.3%) as large cell carcinoma. Redefined LCCs were characterized as middle-age (range 40-80), male (102/110, 92.7%) and smoking patients (64/110, 58.2%) with intermediate-advanced stage. Among 110 cases, 9 cases with EGFR mutation and 10 cases with KRAS mutation and 1 case with ALK fusion were found. No BRAF and ROS1 alterations were identified.@*Conclusions@#According to the new classification, LCCs formerly diagnosed are mostly reclassified as adenocarcinoma and non-keratinizing squamous cell carcinoma. The newly defined LCC may significantly benefit from clinical therapy.

Morphologic Analysis of Pulmonary Neuroendocrine Tumors

BACKGROUND: Few studies on how to diagnose pulmonary neuroendocrine tumors through morphometric analysis have been reported. In this study, we measured and analyzed the characteristic parameters of pulmonary neuroendocrine tumors using an image analyzer to aid in diagnosis. METHODS: Sixteen cases of typical carcinoid tumor, 5 cases of atypical carcinoid tumor, 15 cases of small cell carcinoma, and 51 cases of large cell neuroendocrine carcinoma were analyzed. Using an image analyzer, we measured the nuclear area, perimeter, and the major and minor axes. RESULTS: The mean nuclear area was 0.318+/-0.101 microm2 in typical carcinoid tumors, 0.326+/-0.119 microm2 in atypical carcinoid tumors, 0.314+/-0.107 microm2 in small cell carcinomas, and 0.446+/-0.145 microm2 in large cell neuroendocrine carcinomas. The mean nuclear circumference was 2.268+/-0.600 microm in typical carcinoid tumors, 2.408+/-0.680 microm in atypical carcinoid tumors, 2.158+/-0.438 microm in small cell carcinomas, and 3.247+/-1.276 microm in large cell neuroendocrine carcinomas. All parameters were useful in distinguishing large cell neuroendocrine carcinoma from other tumors (p=0.001) and in particular, nuclear circumference was the most effective (p=0.001). CONCLUSIONS: Pulmonary neuroendocrine tumors showed nuclear morphology differences by subtype. Therefore, evaluation of quantitative nuclear parameters improves the accuracy and reliability of diagnosis.

A Case of Primary Lung Cancer Producing Alpha-fetoprotein / 결핵및호흡기질환

We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.

Research on the anti-tumor effect of Plumbagin against human large cell lung cancer cell line NL9980 / 肿瘤研究与临床

Objective To investigate the anti-tumor effect and mechanism of Plumbagin against human large cell lung cancer cell line NL9980.Methods Plumbagin in different concentrations were set up to administrate NL9980 cell line.MTT test was performed to detect the inhibiting effects against tumor proliferation and IC50 concentration was identified.The influence of tumor apoptosis was observed by flow cytometry and the inhibiting effect against invasive ability was detected by Boyden chamber test.IC50 group and control group were set up and tumor cells were harvested 6 h,24 h and 48 h after administration.Realtime PCR was used to detect mRNA expression changes of bcl-2,bax,VEGF and CYCD1.Results MTT test showed obvious inhibiting effects of proliferation in NL9980 cell line and IC50 was 7.5 μmol/L.Plumbagin induced the apoptosis of tumor cells and showed a significant anti-invasive effect.Mean membrane-spanning cells were 161.59±47.32 and 26.58±9.07 in control group and IC50 group correspondingly.Down-regulations of bcl-2,VEGF and CYCD1 were detected and expression of bax gene increased.The effect of Plumbagin showed obvious time dependance (P ＜0.05).Conclusion Plumbagin has displayed the powerful antitumor effects against NL9980 cell line and it might work via multiple pathways.Plumbagin exhibits the prospect of being an effective drug against large cell lung cancer.

The Fine Needle Aspiration Cytology of a Metastatic Pulmonary Adrenocortical Carcinoma Mimicking Primary Large Cell Carcinoma of the Lung

Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient's history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.

The Fine Needle Aspiration Cytology of a Metastatic Pulmonary Adrenocortical Carcinoma Mimicking Primary Large Cell Carcinoma of the Lung

Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient's history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.

A Case of Large Cell Neuroendocrine Carcinoma of the Colon / 대한소화기학회지

Neuroendocrine carcinoma of the colon can be classified into small cell carcinoma and large cell neuroendocrine carcinoma. The incidence of neuroendocrine carcinoma is so low that the guideline for the treatment of large cell neuroendocrine carcinoma of the colon are not established. The prognosis of large cell neuroendocrine carcinoma of the colon is worse than that of conventional adenocarcinoma of the colon. We report a case of large cell neuroendocrine carcinoma of the colon that treated with right hemicolectomy and 6th sequential combination chemotherapy of 5-fluorouracil and cisplatin. There has been no evidence of the recurrence or metastasis of tumor for 6 months.

Uterine Cervical Large Cell Neuroendocrine Carcinoma Concurrent with High Grade Squamous Intraepithelial Neoplasia: A Case Report

Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is a rare and aggressive malignancy. We report a case of uterine cervical LCNEC concurrent with high grade squamous intraepithelial neoplasia (HG-SIN). The LCNEC expressed chromogranin A and thyroid transcription factor 1 (TTF1). The HG-SIN was negative for these markers. Human papillomavirus (HPV) type 18 was positive in LCNEC whereas both type 16 and 18 were positive in HG-SIN by nested polymerase chain reaction. This case showed TTF1 positivity nonetheless diagnosed as a primary uterine cervical LCNEC confirmed by the detection of HPV genome within the tumor. It is critical to recognize LCNEC of the uterine cervix even in the small biopsy specimen because it is a distinctive clinicopathological entity with highly aggressive behavior and unfavorable outcome.

Large Cell Neuroendocrine Carcinoma of the Lung: A Case Report / 대한흉부외과학회지

A 48-year-old man whose symptom had intermittent right chest pain and x-ray film revealed large mass on right mid lung fields was examined. A conclusive histological diagnosis of large cell neuroendocrine carcinoma was made following bilobectomy. Large cell neuroendocrine carcinoma is an uncommon pulmonary neoplasm, which is characterized by large cell size and low nuclear to cytoplasmic. This tumor shows prominent organoid nests of tumor cells with peripheral palisading and rosette-like structures. We experienced one case of large cell neuroendocrine carcinoma of lung and report it with references.

Large Cell Neuroendocrine Carcinoma of the Lung: A case report / 대한흉부외과학회지

The large cell neuroendocrine carcinoma is uncommon and its diagnostic criteria was recently established as pulmonary neuroendocrine carcinoma. A 74-year-old man who was a heavy smoker without symptoms was presented with a lung mass in right lower lobe. He was diagnosed as having large cell neuroendocrine carcinoma by needle biopsy. He was treated with right lower lobe lobectomy and mediastinal lymph node dissection. We experienced one case of large cell neuroendocrine carcinoma of lung and report it with reference.