Vahidi Shifteh, Stewart Jimmie, Amin Khalid, Racila Emilian, Li Faqian
Cytopathology Fellow, University of Minnesota, Minneapolis 55455.
Associate Professor of Pathology, University of Minnesota, Minneapolis 55455.
Diagn Cytopathol. 2018 Apr;46(4):345-348. doi: 10.1002/dc.23852. Epub 2017 Nov 10.
Calcitonin-secreting neuroendocrine tumors are rare and have been reported in literature as case reports or case series in various organs including lung, pancreas, larynx, bladder, and ovary. These tumors have similar cytologic features and immunohistochemical profile to medullary thyroid carcinoma and thus it is difficult to distinguish them, especially when calcitonin-secreting neuroendocrine tumors are intermediate or higher grade and there is a mass lesion in the thyroid gland. Here, we report a rare case of calcitonin secreting atypical carcinoid tumor of the lung in a patient with thyroid nodule. However, after extensive ancillary studies on the thyroid gland, no tumor was detected and subsequent resection specimen revealed a pulmonary atypical carcinoid tumor with metastasis to level 11 lymph node. Being aware of this entity has significant clinical, diagnostic, and therapeutic implications and can prevent unnecessary thyroidectomies with subsequent possible morbidities.
分泌降钙素的神经内分泌肿瘤较为罕见，文献中多以病例报告或病例系列的形式报道，肿瘤可见于包括肺、胰腺、喉、膀胱和卵巢在内的各种器官。这些肿瘤在细胞学特征和免疫组化方面与甲状腺髓样癌相似，因此难以区分，尤其是当分泌降钙素的神经内分泌肿瘤为中高级别且甲状腺出现肿块病变时。在此，我们报告1例甲状腺结节患者发生的罕见的肺分泌降钙素非典型类癌肿瘤。然而，在对甲状腺进行广泛的辅助检查后，未检测到肿瘤，随后的切除标本显示为肺非典型类癌肿瘤伴11区淋巴结转移。认识到这一实体具有重要的临床、诊断和治疗意义，可避免不必要的甲状腺切除术及其可能带来的并发症。
