• Journal of Gastric Cancer
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• 제19권1호
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• pp.121-131
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• 2019

Purpose: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. Materials and Methods: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED ($P_{NED}$) and demographic and clinicopathological parameters. Results: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. $P_{NED}$, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff $P_{NED}$ was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher $P_{NED}$. Tumors with ${\geq}10%$ NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. Conclusions: GC with ${\geq}10%$ NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.440-448
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• 1996

Bronchial carcinoid tumors are uncommon, constituting approximately 3-5% of all primary lung cancers. Classification of these tumors has evolved substantially as our understanding of the cellular, biologic, and clinical aspects of these neoplasms has improved. Initially, bronchial carcinoids were thought to be benign and therefore were classified as bronchial adenomas. Currently, however, they are well recognized as having the potential for both local invasion and distant metastatic involvement. Consequently, carcinoid tumors are frankly malignant. Thus bronchial adenoma is a misnomer that should no longer be used for bronchial carcinoids. Most investigators currently favor classifying carcinoid tumors as a type of neuroendocrine neoplasm because of their potential to secrete a variety of chemical substances found in both the central nervous system and the epithelial cells of numerous organs. Bronchial carcinoids are usually characterized by a slow growth pattern and a low incidence of metastasis, and histologically conformed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Atypical carcinoid tumor was first defined by Arrigoni et al, who proposed the following criteria for separation of atypical carcinoid from typical carcinoid tumor : 1) increased mitotic activity with 1 mitotic figure per 1-2 high power fields(or 5-10 mitoses /10 HPF), 2) nuclear pleomorphism, hyperchromatism, and an abnormal nuclear-cytoplasmic ratio, 3) areas of increased cellularity with disorganization of the architecture, and 4) tumor necrosis. In contrast, typical carcinoid tumor may have focal cytologic pleomorphism, but necrosis is absent and mitotic figures are rare. Recently we experienced a case of atypical bronchial carcinoid with multiple distant metastasis, so we report this case with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• 제38권1호
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• pp.74-82
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• 1991

Bronchial carcinoid is one of the unusual tumors of the lung, accounting for 1 percent of all lung tumors. Carcinoids, like small cell carcinomas, are generally considered to be derived from a neurosecretary type of cell of the respiratory epithelium, the Kulchtsky's cell. So, they are no longer classified as bronchial adenoma, and are recently grouped into the neuroendocrine group of tumors, the so-called APUD (Amine Precursor Uptake Decarboxylase) group of tumors. Although usually characterized by a slow growth pattern and a low incidence of metastatic disease, bronchial carcinoids should no longer be considered as beingn, and a much higher malignant behavior has been described with a special destignation of 'atypical carcinoid'. Bronchial carcinoids are histologically confirmed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Recently we experienced two cases of bronchial carcinoid, the first case, being peripheral-located and histologically proven as atypical carcinoid, and the second, being central-located and hitologically typical. So we report these cases with a review of the literature.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.419-422
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• 2013

Conventional classifications of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are rather unsatisfactory because of the variation in survival within each subgroup. Molecular markers are being found able to predict patient outcome in more and more tumours. The aim of this study was to characterize the expression of the proteins cyclin D1, cyclin E and P53 in GEP-NETs and assess any prognostic impact. Tumor specimens from 68 patients with a complete follow-up were studied immunohistochemically for cyclin D1, cyclin E and P53 expression. High cyclin D1 and cyclin E immunostaining (${\geq}$ 5% positive nuclei) was found in 48 (71%) and 24 (35%) cases, and high P53 staining (${\geq}$ 10% positive nuclei) in 33 (49%). High expression of P53 was more common in gastric neuroendocrine tumors and related to malignant behavior, being associate with a worse prognosis on univariate analysis (RR=1.9, 95%CI=1.1-3.2). High expression of cyclin E was significantly associated with shorter survival in the univariate analysis (RR=2.0, 95%CI=1.2-3.6) and multivariate analysis (RR=2.1, 95%CI=1.1-4.0). We found no significant correlation between the expression of cyclin D1 and any clinicopathological variables. Our study indicated a prognostic relevance for cyclin E and P53 immunoreactivity. Cyclin E may be an independent prognostic factor from the 2010 WHO Classification which should be evaluated in further studies.

• Tuberculosis and Respiratory Diseases
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• 제50권5호
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• pp.641-644
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• 2001

Pulmonary blastoma is a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or embryonic in appearance. There are three subtypes, which include well differentiated fetal adenocarcinoma (pulmonary endodermal tumor), biphasic pulmonary blastoma, and cystic and pleuropulmonary blastomas in children. Among them, biphasic pulmonary blastoma is a primary malignancy of the lung originating from multipotential pulmonary blastema including both the malignant fetal epithelial and mesenchymal components. These make up 0.25 to 0.5 percent of all primary malignant lung tumors. This tumor is usually symptomatic and appears as a large, solitary peripheral mass, with a tendency to favor the upper lobe. Here we report a case where a small sized asymptomatic peripheral lung mass was diagnosed as a biphasic pulmonary blastoma, prior to the operation, A subsequent percutaneous needle biopsy was performed, which revealed features of a large cell neuroendocrine tumor. In addition, a review of the relevant literature is provided.

• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.98-104
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• 2010

원발성 전 종격동 종양은 종격동 종양의 반이상을 차지하고 그 종류도 다양하다. 흉선 상피 종양이 가장 흔하고 악성 흉선종은 드물다. 생식세포종은 두 번째로 흔한 전 종격동 종양으로 보다 어린나이에 발생하며 대부분 양성이다. 임파종은 대부분 전신성 질환의 흉부 침습 형태로 나타나나 원발성 흉부 임파종은 Hodgkin씨 병이 많다. 저자는 대표적인 전종격동 종양의 임상증상과 영상의학적 소견을 소개한다.

• Journal of Chest Surgery
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• 제47권2호
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• pp.197-199
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• 2014

Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.

• 대한두경부종양학회지
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• 제36권2호
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• pp.51-53
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• 2020

Paraganglioma is a rare benign neuroendocrine tumor arising from the paraganglia of the autonomic nervous system. Paraganglioma occurs mainly in the carotid body, jugular foramen, and vagus nerve in the head and neck region. Herein, we report a case of paraganglioma of the submandibular region that has not been reported. This case highlights paraganglioma as a rare differential diagnosis for submandibular region tumors.

• Investigative Magnetic Resonance Imaging
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• 제25권3호
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• pp.183-188
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• 2021

Tumors that metastasize to the pituitary gland are unusual and metastasis of neuroendocrine neoplasm to the sellar region is extremely rare. We report a 59-year-old man with pituitary metastasis from pulmonary carcinoid tumor who presented with left progressive deterioration of visual field. Sellar dynamic magnetic resonance imaging revealed an enhancing sellar mass invading the left cavernous sinus. We report this unusual case with a review of the relevant literature.

• Journal of Veterinary Science
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• 제24권3호
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• pp.39.1-39.6
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• 2023

A 7-year-old spayed female Shih Tzu dog was presented for evaluation of recurrent hypoglycemia. Serum insulin levels during hypoglycemia were 35.3 µIU/mL. Ultrasonography and computed tomography showed a mesenteric nodule between the kidney and the portal vein, but no pancreatic mass was observed. During surgery, the nodule had neither anatomical adhesions nor vascular connections to the pancreas. Pancreatic inspection and palpation revealed no abnormalities. Hypoglycemia improved after resection of the nodule. Histopathological examination confirmed the nodule to be an islet cell carcinoma. Although extremely rare, ectopic insulinoma should be considered as a possible cause of insulininduced hypoglycemia in dogs.