title: [Pulmonary neuroendocrine cell hyperplasia and tumorlets in bronchiectasis: a clinicopathologic study of 22 cases with review of literature].
abstract: OBJECTIVE
  To study the clinical and pathological features of pulmonary neuroendocrine cell hyperplasia and tumorlets with bronchiectasis.
  
  
  METHODS
  Both the clinicopathologic changes and immunohistochemical findings were examined with microscopy and EnVision method in 22 cases of pulmonary neuroendocrine cell hyperplasia and tumorlets.
  
  
  RESULTS
  The average age of the 22 patients was 53 years, with a male to female ratio of 9:13. On macroscopic examination the lungs showed bronchiectasis; one case was accompanied by gray-white, soft nodules (diameter < 5 mm). Microscopy of the HE sections showed the basic pathologic change was bronchiectasis, accompanied by neuroendocrine cell hyperplasia and tumorlet formation in the pulmonary parenchyma surrounding the bronchioles, presenting as single nodule (10 patients), or multifocal nodules (12 patients), with average size of 1.6 mm in diameter. No tumor cells were identified in the lymph nodes. Sixteen of 22 patients were disease-free after an average follow-up period of 58 months (17 - 117 months); one patient died suddenly after surgery; and five were loss of follow up. Immunohistologically, the tumor cells were positive for CgA (18/18), Syn (16/16), AE1/AE3 (16/16) , TTF-1 (14/15), and CD56 (14/14), and Ki-67 index was < 2% in 12 cases.
  
  
  CONCLUSIONS
  Immunohistological staining for CgA, Syn, CD56, TTF-1 and AE1/AE3 can confirm the diagnosis. Early detection, pulmonary resection and follow-up help prevent the progression of these diseases.
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huo
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Shi
authors.forename: Quan-cai
authors.initials: QC
authors.lastname: Cui
authors.forename: Yu-feng
authors.initials: YF
authors.lastname: Luo
authors.forename: Jin-ling
authors.initials: JL
authors.lastname: Cao
authors.forename: Hong-rui
authors.initials: HR
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001987:Bronchiectasis / Q000473:pathology*; D053379:Chromogranin A / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D019394:Ki-67 Antigen / Q000378:metabolism; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D055099:Neuroendocrine Cells / Q000473:pathology*; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D011013:Pneumonectomy; D016708:Synaptophysin / Q000378:metabolism; D014157:Transcription Factors
chemical_list: D053379:Chromogranin A; D004268:DNA-Binding Proteins; D019394:Ki-67 Antigen; D016708:Synaptophysin; C504003:TTF1 protein, human; D014157:Transcription Factors