Clinicopathological and immunohistochemical analysis of spindle-cell carcinoid tumour of the lung.
OBJECTIVE
To analyse the clinicopathological features and immunohistchemical profile of spindle-cell carcinoid tumours (SCCT) of the lung.


RESULTS
Using a cut-off value of ≥ 50% spindle cells for defining SCCT, 13 were indentified among 80 consecutively resected carcinoid cases. SCCTs are asymptomatic and are peripherally located, well-demarcated tumours. Tumour cells were composed of elongated spindle cells, with scant to moderate amounts of cytoplasm and uniform nuclei with fine granular chromatin. Immunohistochemical analysis revealed that all 13 cases were positive for three neuroendocrine markers (chromogranin A, synaptophysin and CD56). Four tumours (30.7%) were positive for broad-spectrum cytokeratin (CK) and nine tumours (69.2%) were positive for thyroid transcription factor 1. All epithelial components were negative for vimentin, but 12 tumours (92.3%) were positive for stellate-shaped cells (so-called sustentacular cells).


CONCLUSIONS
SCCTs are clinically asymptomatic, peripherally located, well-demarcated tumours, and patients with SCCTs have a favourable outcome. The immunoreactivity pattern of SCCT (low reactivity of broad-spectrum CK and reactivity for vimentin in intratumoral sustentacular cells) might result in a misdiagnosis of SCCT as mesenchymal tumour; therefore, pathologists need to be familiar with this pattern.
Department of Pathology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
Koji
K
Tsuta
Neda
N
Kalhor
Ignacio I
II
Wistuba
Cesar A
CA
Moran
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002276:Carcinoid Tumor / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D014408:Biomarkers, Tumor