Expression of developing neural transcription factors in diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH).
DIPNECH is characterized by neuroendocrine cell hyperplasia, tumorlets, and eventually carcinoid tumors. Although it is regarded by some authors as a preneoplastic condition, this issue is controversial. New pathologic criteria have recently been proposed for the diagnosis of DIPNECH, and a subgroup of carcinoid tumors expressing developing neural transcription factors (DNTFs), with clinicopathologic features similar to those of DIPNECH, has been recognized. This paper reports on the clinical and pathological findings in three cases of DIPNECH and investigates the expression of three DNTFs (TTF1, ASCL1, and POU3F2). All patients were female, with a mean age of 63 years, and all lesions were located in the periphery of the lung. In two cases, typical carcinoids were associated with a spindle-cell component. All neuroendocrine proliferations were DNTF positive. The morphologic (spindle-cell component), phenotypic (DNTF expression), and clinicopathologic (peripheral tumors, female predominance) similarities suggest that DIPNECH may be a preneoplastic lesion for peripheral carcinoids.
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain.
Antonio García
AG
Escudero
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain.
Enrique Rodríguez
ER
Zarco
Department of Thoracic Surgery, "Virgen Macarena" University Hospital, Seville, Spain.
Juan Carlos Girón
JC
Arjona
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain. mjrios@us.es.
María José Ríos
MJ
Moreno
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain.
Katherine Gallardo
KG
Rodríguez
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain.
Ana Vallejo
AV
Benítez
Department of Anatomic Pathology, "Virgen Macarena" University Hospital, Avda, Doctor Fedriani s/n, Seville, 41009, Spain.
Ricardo González
RG
Cámpora
D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D055099:Neuroendocrine Cells / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology*; D014157:Transcription Factors / Q000378:metabolism*
D014157:Transcription Factors
DIPNECH; Developing neural transcription factors; Lung neuroendocrine tumors; Pathology; Preneoplastic lesion