Moran Cesar A
Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Semin Diagn Pathol. 2005 Aug;22(3):223-9. doi: 10.1053/j.semdp.2006.02.007.
Primary neuroendocrine neoplasms occurring in the mediastinum are rare. The spectrum of such tumors can range from low- to high-grade neoplasms. The histogenesis of these tumors is varied, and some of them may originate from ectopic tissues in the mediastinum whereas others represent tumors native to the thymus. Primary thymic neuroendocrine carcinomas therefore need to be separated from other neuroendocrine neoplasms of the mediastinum, namely ectopic parathyroid tumors and paragangliomas. The histopathologic classification of primary neuroendocrine carcinomas of the mediastinum is still under debate and continues to be controversial, as is attested to by the different publications on the topic. Some authors continue to use old terms such as "carcinoid" and "atypical carcinoid" to designate these lesions, whereas others favor the use of a more unifying nomenclature that acknowledges the malignant nature of these lesions, namely that of neuroendocrine carcinoma. However, one aspect that all agree on is that, when they occur in the thymic region, these tumors should be considered as aggressive neoplasms capable of local recurrence and distant metastasis. This review will center on the morphologic spectrum of neuroendocrine carcinomas of the thymus, with special emphasis on diagnostic features and criteria for classification.
发生于纵隔的原发性神经内分泌肿瘤较为罕见。这类肿瘤的范围可从低级别到高级别肿瘤。这些肿瘤的组织发生多种多样，其中一些可能起源于纵隔的异位组织，而其他一些则代表胸腺原发的肿瘤。因此，原发性胸腺神经内分泌癌需要与纵隔的其他神经内分泌肿瘤区分开来，即异位甲状旁腺肿瘤和副神经节瘤。纵隔原发性神经内分泌癌的组织病理学分类仍存在争议，不同的相关出版物也证实了这一点。一些作者继续使用诸如“类癌”和“非典型类癌”等旧术语来指代这些病变，而另一些人则倾向于使用更统一的命名法，承认这些病变的恶性本质，即神经内分泌癌。然而，所有人都认同的一个方面是，当这些肿瘤发生在胸腺区域时，应被视为具有局部复发和远处转移能力的侵袭性肿瘤。本综述将聚焦于胸腺神经内分泌癌的形态学范围，特别强调诊断特征和分类标准。
