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Presented by Pedram Argani, M.D. and prepared by Carla Ellis, M.D.
Case 2: This is a 71-year-old female with a lung mass.
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Question 1 of 1
1. Question
Week 447: Case 2
This is a 71-year-old female with a lung mass.images/1Alex/08162010case2image1.jpg
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images/1Alex/08162010case2image5.jpgCorrect
Answer: Small cell carcinoma
Histology: This is a cellular small blue cell neoplasm with a high mitotic rate and extensive necrosis. The nuclei are hyperchromatic and demonstrate nuclear molding. Nucleoli are not prominent. These are the typical features of small cell carcinoma of the lung.
Discussion: Carcinoid tumors should lack tumoral necrosis, and have minimal mitotic activity. Atypical carcinoids may demonstrate punctate areas of necrosis, but their mitotic count should be less than 10/10 high power fields. Large cell neuroendocrine carcinoid may demonstrate abundant necrosis, but their cytologic features are different from small cell carcinoma. Specifically, large cell neuroendocrine carcinoma features cells with vesicular chromatin and prominent nucleoli.
An additional finding in this case is the presence of interstitial amyloid in the surrounding pulmonary parenchyma.
Incorrect
Answer: Small cell carcinoma
Histology: This is a cellular small blue cell neoplasm with a high mitotic rate and extensive necrosis. The nuclei are hyperchromatic and demonstrate nuclear molding. Nucleoli are not prominent. These are the typical features of small cell carcinoma of the lung.
Discussion: Carcinoid tumors should lack tumoral necrosis, and have minimal mitotic activity. Atypical carcinoids may demonstrate punctate areas of necrosis, but their mitotic count should be less than 10/10 high power fields. Large cell neuroendocrine carcinoid may demonstrate abundant necrosis, but their cytologic features are different from small cell carcinoma. Specifically, large cell neuroendocrine carcinoma features cells with vesicular chromatin and prominent nucleoli.
An additional finding in this case is the presence of interstitial amyloid in the surrounding pulmonary parenchyma.
