PubMed · 13793974
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H S APPLEBAUM. 1960. Functioning carcinoids with case report.. https://pubmed.ncbi.nlm.nih.gov/13793974/
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Neuroendocrine tumors of the lung can be seen as a separate entity, in accordance with the recommendations of the WHO classification of 1999, in terms of immunohistochemical findings in biopsy material as well as in more extensive resections. The characterization of carcinoid tumors and small cell lung cancer by the pathologist according to histomorphological and cytological criteria is commonly accepted, and is of decided importance with regard to clinical questions and therapeutic measures.However, it is still unclear whether the "new" group of large cell neuroendocrine carcinomata of the lung has to be regarded as a separate entity with clinical and therapeutic relevance, or whether this group remains within the non-small cell lung cancers as a special form of differentiation. These complex questions can only be answered by studies targeting the course of the disease and the results of therapy.
The diffuse neuroendocrine cell system of the gastrointestinal tract gives rise to the neuroendocrine neoplasms. The WHO classification distinguishes between well differentiated neuroendocrine tumors of benign or uncertain behavior, well differentiated neuroendocrine carcinomas of low grade malignancy and poorly differentiated neuroendocrine carcinomas of high grade malignancy. The well differentiated neuroendocrine tumors and carcinomas correspond to the carcinoids of earlier classifications. Further biological and prognostic classification of these neoplasms must consider the localization of the tumors within the gastrointestinal tract. This system allows a clinically relevant diagnosis and includes all so far known tumor entities.
Carcinoid tumors are relatively rare neuroendocrine malignancies with an indolent clinical behavior. The majority of cases arise within the gastrointestinal tract, but they may also be encountered in other organs such as the bronchial system. While occurrence of carcinoid tumors has been reported in association with the multiple endocrine neoplasia (MEN) type I syndrome, no clear-cut risk factors have been established for the development of these malignancies. We report the case of a 50-year-old woman who was diagnosed with a pulmonary carcinoid in 2001 after having undergone allogeneic stem cell transplantation for chronic myeloid leukemia (CML) in 1997. This is the first case report of a carcinoid tumor following allogeneic bone marrow transplantation. At the moment, however, an association with CML as well as a causative role of transplantation and intake of immunosuppressants remains speculative. Apart from highlighting the occurrence of a carcinoid in this setting, our case again underscores the importance of nuclear medicine methods, i.e., somatostatin receptor scintigraphy, in staging and follow-up of patients with carcinoid tumors.