Title: Spectrum of Primary Pulmonary Neuroendocrine Tumors from A Regional Cancer Center in South India

Authors: Dr Usha Amirtham, Dr Nikita J.Mulchandani, Dr Premalata C.S., Dr Shankar Anand Bharatnur, Dr Rekha V.Kumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.114

Abstract

Objectives: To determine the clinico-pathologic features of pulmonary neuroendocrine tumors (NET) in a regional cancer center in South India.

Methods: 89 cases of NETs were identified over a 5-year period from May 2011 to May 2016. The clinico-pathologic and immunophenotypic features of these tumors were analyzed on needle core biopsies and they were classified according to the 2015 World Health Organization Classification of tumors of lung. Cases on which the diagnosis was made on cell blocks of aspirated material were excluded.

Results: There were 89 cases of NETs, of which 72 (81%) had lung biopsies and 17 (19%) had biopsies from metastatic sites. Among the NETs, 10 (11.2%) were carcinoid tumors and 79 were neuroendocrine carcinomas (88.8%). Of the 79 cases of neuroendocrine carcinomas, 65 (82%) were small cell lung cancers and 14 (17%) were possible large cell neuroendocrine carcinomas. The mean ages for pulmonary carcinoid and NEC were 44.5 years and 55.5 years respectively. The male to female ratio was 1.5:1 in case of pulmonary carcinoids and 7.9:1 in case of NECs. While 3 (30%) pulmonary carcinoids were central in location, 7 (70%) were peripheral and whereas 16 (20.3%) NECs were central in location, 46 (58.2%) were peripheral. Also, 17 (21.5%) cases presented with metastases in various sites which included cervical and supraclavicular lymph nodes, liver, brain, abdominal wall and bone.

Conclusion: Our study was an attempt to analyze the histopathological spectrum of pulmonary NETs, the first of its kind in the Indian literature. We noted marked preponderance of small cell neuroendocrine carcinomas amongst all NETs.

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Corresponding Author

Dr Shankar Anand Bharatnur

Assistant Professor, Department of Pathology,

Kidwai Cancer Institute, Bengaluru