Large cell neuroendocrine carcinoma of the Larynx: Definition of an entity

被引：44

作者：

Lewis Jr. J.S. ^{[1
]}

Spence D.C. ^{[2
]}

Chiosea S. ^{[3
]}

Barnes Jr. E.L. ^{[3
]}

Brandwein-Gensler M. ^{[4
]}

El-Mofty S.K. ^{[5
]}

机构：

[1] Departments of Pathology and Immunology, Otolaryngology Head and Neck Surgery, Washington University in St. Louis, St. Louis, MO 63110, 660 South Euclid Ave.

[2] Department of Pathology, University of Utah, Salt Lake City, UT 84112

[3] Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15621

[4] Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294

[5] Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO

来源：

Head and Neck Pathology | 2010年 / 4卷 / 3期

关键词：

Atypical carcinoid; Large cell; Larynx; Neuroendocrine carcinoma; WHO classification;

D O I：

10.1007/s12105-010-0188-0

中图分类号：

学科分类号：

摘要：

Laryngeal atypical carcinoids (AC/moderately-differentiated neuroendocrine carcinoma) are associated with moderately aggressive clinical behavior; however, a subset of tumors classified as AC have much greater aggressive potential. These tumors fulfill the proposed diagnostic criteria for pulmonary large cell neuroendocrine carcinoma, albeit in the larynx. In the current WHO classification, laryngeal large cell neuroendocrine carcinomas (LCNEC) are classified as variants of AC, whereas pulmonary LCNEC are classified as poorly-differentiated neuroendocrine carcinomas. Reported outcomes for pulmonary tumors support the separate classification of LCNEC. Five and ten year survival rates for pulmonary AC are 61-73, and 35-59%, respectively, while the 5-year survival rate for pulmonary LCNEC is as low as 30%. By extension, we postulate that the biologic potential of laryngeal LCNEC is similar to that of small-cell carcinoma (poorly-differentiated neuroendocrine carcinoma), and as such, warrants reclassification. The files of Barnes Jewish Hospital/Washington University were searched for the term "neuroendocrine" and the anatomic subsite larynx. Neuroendocrine carcinoma cases were evaluated using the WHO definitions for pulmonary AC and LCNEC; small cell carcinoma was excluded. Cases were also solicited from the larger head and neck pathology community. A literature search was also performed for cases of laryngeal neuroendocrine carcinoma, and cases which could be clearly classified as LCNEC by this scheme were captured as well. Six new cases plus four reported cases were identified which fulfill the WHO criteria for pulmonary LCNEC (eight men and two women). Nine patients presented at stage IV and 88% died of disease (DOD), 75 and 100% of these at 2 and 3 years, respectively. Laryngeal LCNEC is a rare entity, distinct from AC. We recommend that laryngeal tumors fulfilling WHO criteria for pulmonary LCNEC not be classified as variants of AC, but as variants of small cell carcinoma (poorly-differentiated neuroendocrine carcinoma) as they are associated with poorer outcome. © 2010 Humana.

引用

页码：198 / 207

页数：9

共 28 条

[1]

Beasley M.B., Thunnissen F.B., Hasleton P.S., Pathology and genetics tumors of the lung, pleura, thymus, and heart, World Health Organization Classification of Tumours, (2004)

[2]

Ferlito A., Silver C.E., Bradford C.R., Et al., Neuroendocrine neoplasms of the larynx: an overview, Head Neck, 31, pp. 1634-1646, (2009)

[3]

Wenig B.M., Hyams V.J., Heffner D.K., Moderately differentiated neuroendocrine carcinoma of the larynx-a clinicopathologic study of 54 cases, Cancer, 62, 12, pp. 2658-2676, (1988)

[4]

Woodruff J., Jatin P., Huvos A., Et al., Neuroendocrine carcinomas of the larynx: a study of two types, one of which mimics thyroid medullary carcinoma, Am J Surg Path, 9, 22, pp. 771-790, (1985)

[5]

Zhang M., Zhou L., Cai L., Et al., Moderately differentiated neuroendocrine carcinoma of the larynx, Acta Oto-Laryngol, 130, pp. 498-502, (2010)

[6]

Travis W.D., Linnoila R.I., Tsokos M.G., Neuroendocrine tumors of the lung with proposed criteria for large-cell neuroendocrine carcinoma. An ultrastructural, immunohistochemical, and flow cytometric study of 35 cases, Am J Surg Pathol, 15, pp. 529-533, (1991)

[7]

Greene L., Brundage W., Cooper K., Large cell neuroendocrine carcinoma of the larynx: a case report and a review of the classification of this neoplasm, J Clin Pathol, 58, pp. 658-661, (2005)

[8]

Chung J., Lee S., Shim Y., Et al., A study of moderately differentiated neuroendocrine carcinomas of the larynx and an examination of non-neoplastic larynx tissue for neuroendocrine cells, Laryngoscope, 114, pp. 1264-1270, (2004)

[9]

Capelli M., Bertino G., Morbini P., Et al., Neuroendocrine carcinomas of the upper airways: a small case series with histopathological considerations, Tumori, 93, pp. 499-503, (2007)

[10]

Beasley M.B., Thunnissen F.B., Branbilla E., Et al., Pulmonary atypical carcinoid: predictors of survival in 106 cases, Hum Pathol, 31, pp. 1255-1265, (2000)

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