Thyroid & Adrenal
Whch statements is true regarding carci-noids in the lung?
|A||They frequently metastasize|
|B||They most commonly arise in peripheral terminal bronchioles|
|C||They rarely produce the carcinoid syndrome|
|D||They are radiosensitive|
a. Neuroendocrine lung tumors represent a spectrum of pathologic entities, including typical carcinoid, atypical carcinoid, and large cell neuroendocrine cancer, as well as SCLC.
b. SCLC and large cell neuroendocrine cancer are high-grade neuroendocrine tumors and in general should be treated as described for SCLC.
c. By contrast, typical carcinoid and atypical carcinoids are low- and intermediate-grade tumors with different treatment approaches and in general are resistant to chemotherapy .
d. Carcinoids, like SCLCs, may secrete other hormones, such as ACTH or AVP, and can cause paraneoplastic syndromes that resolve on resection.
e. Uncommonly, bronchial carcinoid metastases (usually to the liver) may produce the carcinoid syndrome, with cutaneous flush, bronchoconstriction, diarrhea, and cardiac valvular lesions, which SCLC does not do.
f. Carcinoid tumors that have an unusually aggressive histologic appearance (referred to as atypical carcinoids) metastasize in 70% of cases to regional nodes, liver, or bone, compared with only a 5% rate of metastasis for carcinoids with typical histology.
g. Large cell neuroendocrine cancer is a high-grade NSCLC with neuroendocrine features.
h. These tumors are characterized by histologic features similar to small cell cancer, but they are formed by larger cells.
i. The prognosis for patients with large cell neuroendocrine cancer is significantly worse than that for patients with atypical carcinoid and classic large cell cancer.
j. Five-year survival is 21% for patients with large cell neuroendocrine cancer, 65% for atypical carcinoid, and 90% for typical carcinoid.