| Partial expectoration of a typical carcinoid: report
of a case with diagnosis on sputum cytology. Acta
Cytol. 2006 Sep-Oct;50(5):581-3.
BACKGROUND: Typical carcinoid (TC) tumors are
relatively infrequent. Diagnosis on the basis of sputum cytology is
difficult, and there are few cases reported in the literature. Partial
expectoration of endobronchial tumors is a rare event that permits
their cytologic diagnosis. CASE: A 71-year-old, male nonsmoker sought
medical attention for a cough and expectoration of 1 month's duration.
After 2 negative sputum tests, the third sample revealed large tumor
fragments as a result of partial expectoration of an endobronchial,
growing mass. CONCLUSION: The diagnosis of TC is rarely made by sputum
examination as the tumor is generally covered with intact bronchial
mucosa. However, in our case there was partial expectoration of the
tumor. This has been reported just once before in the literature.
Cytopathology of pulmonary carcinoid tumors in sputum and bronchial
brushings.Acta Cytol.
1995 Nov-Dec;39(6):1152-60
OBJECTIVE: To study the cytologic manifestations
of bronchial carcinoid tumor (BCT) in sputum and bronchial brushing
(BB). STUDY DESIGN: A diagnosis of BCT was made by sputum examination
in 1 case and by BB cytology in 12 cases with central and typical BCTs.
The tumor was suspected in three patients whose sputa were too scanty
in diagnostic cells. Three patients with central and typical BCTs
yielded only a few tumor cells in BB samples and were suspected of
having BCT. In three patients with central and atypical BCT, a
diagnosis of oat cell carcinoma was made in two cases and typical BCT
in the third case by BB. One case of peripheral and typical BCT was
correctly identified by BB. In BB samples the typical BCTs showed
tumor cells singly and in loose clusters. They displayed oval nuclei,
fine chromatin clumping, micronucleoli and ill-defined, variable
cytoplasm. The number of tumor cells with plasmacytoid configuration
varied from case to case and was abundant in one patient. The
peripheral BCT was predominantly composed of spindle cells and in BB
samples showed single and loosely clustered cells with ill-defined
cytoplasm and cigar-shaped nuclei. Two atypical BCTs yielded
pleomorphic cells displaying scant cytoplasm, nuclear molding, fine
chromatin and rare micronucleoli, similar to those of oat cell
carcinoma, but the smear background was free of necrotic debris.
CONCLUSION: BCTs rarely exfoliate their cells in sputum, and bronchial
brushing is efficient in detecting BCT cells that show distinctive
cytologic features of the tumors.
Exfoliative cytopathology of atypical pulmonary carcinoid: a case
report.Jpn
J Clin Oncol. 1986 Dec;16(4):413-9
A 35-year-old man was diagnosed as having lung
cancer and died six years later. In spite of an initial histological
diagnosis of squamous cell carcinoma from the biopsy material, the
correct diagnosis of atypical carcinoid was made by sputum cytology.
The carcinoid cells had exfoliated into the sputum collected
immediately after bronchofiberscopic examination although the
bronchial tissues obtained at this time did not reveal any
histological findings suggestive of neoplasia. The distinctive
cytological features in sputum of atypical carcinoid that
differentiate it from small cell carcinoma are considered to be the
relatively abundant vesicular cytoplasm and the finely reticular or
granular chromatin pattern observed in well-preserved tumor cells. The
present case also suggests that clinical data may be indispensable to
the differential cytological diagnosis of such tumors.
A review of cytologic findings in neuroendocrine carcinomas
including carcinoid tumors with histologic correlation.Cancer.
2000 Jun 25;90(3):148-61.
BACKGROUND: The nosology of neuroendocrine
neoplasia has evolved substantially in recent years. The aim of this
study was to review the authors' institutional experience and
diagnostic accuracy for cytologic specimens of neuroendocrine
carcinoma (NEC) and to identify features most suggestive of
neuroendocrine differentiation. METHODS: The cytologic and histologic
findings of 29 archival NEC in which cytology preceded biopsy or
resection were compared. The study was comprised of 6 carcinoid
tumors, 3 atypical carcinoid tumors, 17 high grade NEC (5 small cell,
9 large cell, and 3 mixed small/large cell), and 3 combined NEC/nonneuroendocrine
carcinomas. Cytologic material was derived from 21 fine-needle
aspirates (FNA), 6 bronchial brushing/washings, and 2 gastrointestinal
tract brushings. RESULTS: Of the 29 cases, the correct cytologic
diagnosis was rendered in 11. Two cases were identified as NEC but
were graded incorrectly. The remaining 16 cases were interpreted as
nonsmall cell carcinoma (8 cases); diagnostic or suspicious of
carcinoma, not otherwise specified (7 cases); and atypical,
indeterminate for malignancy (1 case). On review, neuroendocrine
features were identified in 14 of the latter 16 cases. CONCLUSIONS:
The cytologic diagnosis of NEC, both high and low grade, can be
difficult. Because of acinus-like formations and columnar cell shapes,
low grade NEC may be mistaken for adenocarcinoma. Small cell
carcinomas, especially in bronchial brush and wash preparations, may
be difficult to classify beyond malignant. Large cell NEC may be
confused with nonneuroendocrine carcinomas because of abundant
cytoplasm and nucleoli. Attention to the presence of loose cell
aggregates in a background of singly dispersed cells; feathery
patterns created by tumor cells clinging to capillaries; rosette
formations; delicate, granular cytoplasm; inconspicuous nucleoli;
molding in high grade tumors; and, most important, speckled or dusty
chromatin patterns are useful in identifying neuroendocrine
differentiation in cytologic specimens.
Cytopathology of oncocytic carcinoid tumor of the lung mimicking
granular cell tumor. A case report.Acta
Cytol. 2000 Mar-Apr;44(2):247-50.
BACKGROUND: The cytopathologic features of oncocytic carcinoid
tumor of the lung, a rare variant of carcinoid tumor that is composed
exclusively of oncocytes, have not been described before in detail.
CASE: The bronchial brush smears from an 80-year-old female with an
endobronchial obstructive tumor showed single and loose clusters of
tumor cells with abundant granular, eosinophilic cytoplasm. The
differential diagnoses included oncocytic carcinoid tumor, granular
cell tumor, other oncocytic tumors of bronchial origin and metastatic
oncocytic tumors. Immunocytochemistry and electron microscopy
confirmed the diagnosis of oncocytic carcinoid tumor. CONCLUSION:
Oncocytic carcinoid tumor of the lung has cytopathologic features
similar to those of granular cell tumor and pulmonary oncocytoma.
Immunocytochemistry, electron microscope or both are necessary to
distinguish these neoplasms.
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