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[肺神经内分泌肿瘤。从小细胞肺癌到弥漫性特发性肺神经内分泌细胞增生]

[Neuroendocrine tumors of the lungs. From small cell lung carcinoma to diffuse idiopathic pulmonary neuroendocrine cell hyperplasia].

作者信息

Schnabel P A, Junker K

机构信息

Institut für Allgemeine und Spezielle Pathologie, Universitätsklinikum des Saarlandes, Gebäude 26, 66421, Homburg/Saar, Deutschland,

出版信息

Pathologe. 2014 Nov;35(6):557-64. doi: 10.1007/s00292-014-1917-z.

DOI:10.1007/s00292-014-1917-z
PMID:25366372
Abstract

The new World Health Organization (WHO) classification announced for 2015 will for the first time present all neuroendocrine tumors (NET) of the lungs in one single section. In this classification high grade small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC) will be discriminated from intermediate grade atypical carcinoid (AC) and low grade typical carcinoid as well as from the preinvasive lesion diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH). The LCNEC was previously listed under the section of large cell carcinomas. The LCNEC could previously be diagnosed according to the current WHO classification from 2004 which is designed for resection specimens. According to this the main diagnostic criteria are a neuroendocrine growth pattern which can be difficult or impossible to detect in biopsy material, non-small cell cytological features, more than 10 mitoses per 2 mm(2) (mean 70-80 per 2 mm(2)), tumor cell necrosis, and an immunohistochemical positivity for at least one neuroendocrine marker other than neuron-specific enolase (NSE). The presentation of all neuroendocrine tumors of the lungs in one section allows a more direct comparison and a better differential diagnostic discrimination of the different entities.

摘要

世界卫生组织(WHO)公布的2015年新版分类将首次把所有肺神经内分泌肿瘤(NET)归在同一章节中呈现。在该分类中,高级别小细胞肺癌(SCLC)和大细胞神经内分泌癌(LCNEC)将与中级别非典型类癌(AC)、低级别典型类癌以及浸润前病变弥漫性特发性肺神经内分泌细胞增生症(DIPNECH)区分开来。LCNEC以前被列在大细胞癌章节下。LCNEC以前可根据2004年现行的WHO分类(该分类针对切除标本)进行诊断。据此,主要诊断标准为神经内分泌生长模式(在活检材料中可能难以或无法检测到)、非小细胞细胞学特征、每2平方毫米超过10个核分裂象(平均每2平方毫米70 - 80个)、肿瘤细胞坏死以及对至少一种除神经元特异性烯醇化酶(NSE)之外的神经内分泌标志物呈免疫组化阳性。将所有肺神经内分泌肿瘤归在同一章节中呈现,便于对不同实体进行更直接的比较和更好的鉴别诊断。

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Frequent mutations in chromatin-remodelling genes in pulmonary carcinoids.肺类癌中染色质重塑基因的频繁突变。
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