Department of Pathology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
Histopathology. 2011 Sep;59(3):526-36. doi: 10.1111/j.1365-2559.2011.03966.x.
To analyse the clinicopathological features and immunohistchemical profile of spindle-cell carcinoid tumours (SCCT) of the lung.
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).
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.
分析肺梭形细胞类癌（SCCT）的临床病理特征和免疫组织化学特征。
使用≥50%梭形细胞定义 SCCT，在连续切除的 80 例类癌病例中鉴定出 13 例 SCCT。SCCT 患者无症状，位于肺外周，边界清楚的肿瘤。肿瘤细胞由长梭形细胞组成，细胞浆稀少至中等量，核均匀，染色质呈细颗粒状。免疫组织化学分析显示，所有 13 例均对三种神经内分泌标志物（嗜铬粒蛋白 A、突触素和 CD56）呈阳性。4 例肿瘤（30.7%）对广谱细胞角蛋白（CK）呈阳性，9 例肿瘤（69.2%）对甲状腺转录因子 1 呈阳性。所有上皮成分均对波形蛋白呈阴性，但 12 例肿瘤（92.3%）对星状细胞（所谓的支持细胞）呈阳性。
SCCT 患者无症状，位于肺外周，边界清楚，预后良好。SCCT 的免疫反应模式（广谱 CK 反应性低，肿瘤内支持细胞的波形蛋白反应性）可能导致 SCCT 被误诊为间叶肿瘤；因此，病理学家需要熟悉这种模式。
