Hayoune Amine, Mahfoud Imane, Thouil Afaf, Kouismi Hatim
Department of Respiratory Diseases, Faculty of Medicine and Pharmacy of Oujda, Mohammed VI University Hospital, Mohamed First University, Oujda, MAR.
Department of Respiratory Diseases, Research and Medical Sciences Laboratory, Faculty of Medicine and Pharmacy of Oujda, Mohammed VI University Hospital, Mohamed First University, Oujda, MAR.
Cureus. 2022 Aug 1;14(8):e27559. doi: 10.7759/cureus.27559. eCollection 2022 Aug.
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of neuroendocrine tumor, presenting with very aggressive behavior and a poor prognosis. The diagnosis is difficult and requires histological confirmation of the neuroendocrine nature by an immunohistochemical study on a biopsy sample. We retrospectively studied a series of 14 patients from the pneumology department of the Mohammed VI University Hospital of Oujda, Morocco, over a period of five years (from April 2017 to March 2021). The average age was 63.41 years (45-80 years). All our patients were male and smokers. The clinical signs were dominated by deterioration in general condition and dyspnea. Bronchoscopy was performed in 92% of patients, with neoplastic stenosis being the main found aspect, in 35% of cases. The histological diagnosis was obtained by bronchoscopy in 50% of cases. In the remaining cases, it was carried by CT-guided transparietal biopsy in 28% of cases, pleural biopsy in 7% of cases, biopsy of a metastatic site in 7% of cases and finally thoracoscopy with pleural biopsy in the remaining 7% of cases. Therapeutically, no patient received surgical treatment and three patients were put on palliative treatment. The positive diagnosis is often late, which makes the prognosis bad and the therapeutic possibilities limited. Hence the importance of strategies for the prevention of tobacco control and early detection in population at risk.
肺大细胞神经内分泌癌（LCNEC）是神经内分泌肿瘤的一种罕见亚型，具有非常侵袭性的行为和较差的预后。诊断困难，需要通过对活检样本进行免疫组织化学研究来证实神经内分泌性质。我们回顾性研究了摩洛哥乌季达穆罕默德六世大学医院肺病科在五年期间（2017年4月至2021年3月）的14例患者。平均年龄为63.41岁（45 - 80岁）。我们所有的患者均为男性且吸烟。临床症状以全身状况恶化和呼吸困难为主。92%的患者进行了支气管镜检查，其中35%的病例主要发现为肿瘤性狭窄。50%的病例通过支气管镜检查获得组织学诊断。在其余病例中，28%通过CT引导下经壁活检、7%通过胸膜活检、7%通过转移部位活检，最后7%通过胸腔镜联合胸膜活检获得诊断。在治疗方面，没有患者接受手术治疗，3例患者接受了姑息治疗。阳性诊断往往较晚，这使得预后不良且治疗可能性有限。因此，在高危人群中开展烟草控制预防和早期检测策略非常重要。
