M 23, Mild dyspnea and dry cough

1
M 23, Mild dyspnea and dry cough
A bronchial mass in RML bronchus extending to the
bronchus intermedius
Organoid and trabecular growing pattern
suggesting neuroendocrine differentiation. The
tumor cells have uniform cytologic featureswith
moderate eosinophilic, finely granular cytoplasm
and nuclei with a finely granular chromatin
pattern.
Carcinoid
Obstructive pneumonia and bronchiectasis
16248594
2
Carcinoid tumor

• A tumor that is characterized by growth patterns
  such as organoid, trabecular, insular,
  palisading, ribbon or rosette-like arrangements
  which suggest neuroendocrine differentiation. The
  tumor cells have uniform cytologic features with
  moderate eosinophilic, finely granular cytoplasm
  and nuclei with a finely granular chromatin
  pattern. Nucleoli may be present but are more
  frequent in atypical carcinoids. Carcinoids can
  have papillary, sclerosing, follicular and
  glandular features. Focal spindle cell and
  oxyphilic features are common. Unusual cytologic
  features include mucin and melanin production and
  prominent nuclear convolutions. Stromal changes
  including bone, cartilage, dense fibrosis and
  amyloid can be seen. These tumors may be
  accompanied by NCH in the airway epithelium,
  sometimes associated with airway fibrosis, which
  is most often in associated with peripheral
  carcinoids. In vary rare cases the underlying
  condition of DIPNECH is found, often with
  multiple tumorlets and sometimes with multiple
  carcinoid tumors

3
Typical carcinoid versus Atypical carcinoid

• Typical carcinoidA carcinoid tumor with fewer
  than two mitoses per 2 mm2 of viable tumor (ten
  high-power fields) and lacking necrosis. Some of
  these tumors show cytologic atypia, increased
  cellularity and lymphatic invasion.
• Atypical carcinoidA carcinoid tumor with between
  two and ten mitoses per 2 mm2 of viable tumor
  (ten high-power fields) and/or necrosis, which is
  usually punctuate. Other criteria, which are
  more subjective include cytologic atypia,
  lymphatic invasion, nucleoli, increased
  cellularity and disorganized architecture.