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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
- Obsolete synonyms for small cell lung cancer (SCLC)
- Oat cell carcinoma
- Small cell anaplastic carcinoma
- Undifferentiated small cell carcinoma
- Intermediate cell-type small cell carcinoma
- Mixed small cell/large cell carcinoma
- Obsolete synonyms for small cell lung cancer (SCLC)
Definitions
- Neuroendocrine (NE) neoplasms
- Storage, synthesis, and secretion of peptide hormones or bioamines
- Histologic patterns similar to nonneoplastic NE cells
- Trabecular or nesting growth pattern
- Cells with coarsely stippled nuclear chromatin
- Neurosecretory protein production detectable on immunohistochemical stains
- Typically chromogranin A and synaptophysin
- Subdivided into well- and poorly-differentiated NE neoplasms
- Pulmonary NE neoplasms (25% of all NE neoplasms)
- Malignant pulmonary neoplasms of NE origin
- Thought to arise from normal Kulchitsky and NE cells of bronchial mucosa
- WHO classification of Neuroendocrine Tumors (NET)
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
- Pre-invasive lesion for lung carcinoid tumor
- Characterized by proliferation of NE cells in bronchial wall
- Well-differentiated NE neoplasms
- NET grade 1: Typical carcinoid (TC); low grade
- NET grade 2: Atypical carcinoid (AC); intermediate grade
- Poorly-differentiated NE neoplasms
- NET grade 3: Small cell lung carcinoma (SCLC); high grade
- NET grade 4: Large cell neuroendocrine carcinoma (LCNEC); high grade
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
- SCLC
- Most common and most aggressive NE carcinoma
- 13-15% of all lung cancers
- Thought to arise centrally in mainstem or lobar bronchi
- Neuroendocrine (NE) neoplasms
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
- Crown A et al: Impact of initial imaging with gallium-68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors. J Surg Oncol. 121(3):480-5, 2020
- Mengoli MC et al: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) Syndrome and carcinoid tumors with/without NECH: a clinicopathologic, radiologic, and immunomolecular comparison study. Am J Surg Pathol. 42(5):646-55, 2018
- Baxi AJ et al: Multimodality imaging findings in carcinoid tumors: a head-to-toe spectrum. Radiographics. 37(2):516-36, 2017
- Deppen SA et al: Safety and efficacy of 68Ga-DOTATATE PET/CT for diagnosis, staging, and treatment management of neuroendocrine tumors. J Nucl Med. 57(5):708-14, 2016
- Klimstra DS et al: The spectrum of neuroendocrine tumors: histologic classification, unique features and areas of overlap. Am Soc Clin Oncol Educ Book. 35:92-103, 2015
- Carter BW et al: Small cell lung carcinoma: staging, imaging, and treatment considerations. Radiographics. 34(6):1707-21, 2014
- Benson RE et al: Spectrum of pulmonary neuroendocrine proliferations and neoplasms. Radiographics. 33(6):1631-49, 2013
- Lu HY et al: Targeted therapies in small cell lung cancer. Oncol Lett. 5(1):3-11, 2013
- Gaspar LE et al: Small-cell lung cancer: prognostic factors and changing treatment over 15 years. Clin Lung Cancer. 13(2):115-22, 2012
- Kalemkerian GP: Staging and imaging of small cell lung cancer. Cancer Imaging. 11:253-8, 2012
- Travis WD: Advances in neuroendocrine lung tumors. Ann Oncol. 21 Suppl 7:vii65-71, 2010
- Vallières E et al: The IASLC Lung Cancer Staging Project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 4(9):1049-59, 2009
- Franks TJ et al: Lung tumors with neuroendocrine morphology: essential radiologic and pathologic features. Arch Pathol Lab Med. 132(7):1055-61, 2008
- Chong S et al: Neuroendocrine tumors of the lung: clinical, pathologic, and imaging findings. Radiographics. 26(1):41-57; discussion 57-8, 2006
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Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
- Obsolete synonyms for small cell lung cancer (SCLC)
- Oat cell carcinoma
- Small cell anaplastic carcinoma
- Undifferentiated small cell carcinoma
- Intermediate cell-type small cell carcinoma
- Mixed small cell/large cell carcinoma
- Obsolete synonyms for small cell lung cancer (SCLC)
Definitions
- Neuroendocrine (NE) neoplasms
- Storage, synthesis, and secretion of peptide hormones or bioamines
- Histologic patterns similar to nonneoplastic NE cells
- Trabecular or nesting growth pattern
- Cells with coarsely stippled nuclear chromatin
- Neurosecretory protein production detectable on immunohistochemical stains
- Typically chromogranin A and synaptophysin
- Subdivided into well- and poorly-differentiated NE neoplasms
- Pulmonary NE neoplasms (25% of all NE neoplasms)
- Malignant pulmonary neoplasms of NE origin
- Thought to arise from normal Kulchitsky and NE cells of bronchial mucosa
- WHO classification of Neuroendocrine Tumors (NET)
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
- Pre-invasive lesion for lung carcinoid tumor
- Characterized by proliferation of NE cells in bronchial wall
- Well-differentiated NE neoplasms
- NET grade 1: Typical carcinoid (TC); low grade
- NET grade 2: Atypical carcinoid (AC); intermediate grade
- Poorly-differentiated NE neoplasms
- NET grade 3: Small cell lung carcinoma (SCLC); high grade
- NET grade 4: Large cell neuroendocrine carcinoma (LCNEC); high grade
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
- SCLC
- Most common and most aggressive NE carcinoma
- 13-15% of all lung cancers
- Thought to arise centrally in mainstem or lobar bronchi
- Neuroendocrine (NE) neoplasms
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
- Crown A et al: Impact of initial imaging with gallium-68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors. J Surg Oncol. 121(3):480-5, 2020
- Mengoli MC et al: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) Syndrome and carcinoid tumors with/without NECH: a clinicopathologic, radiologic, and immunomolecular comparison study. Am J Surg Pathol. 42(5):646-55, 2018
- Baxi AJ et al: Multimodality imaging findings in carcinoid tumors: a head-to-toe spectrum. Radiographics. 37(2):516-36, 2017
- Deppen SA et al: Safety and efficacy of 68Ga-DOTATATE PET/CT for diagnosis, staging, and treatment management of neuroendocrine tumors. J Nucl Med. 57(5):708-14, 2016
- Klimstra DS et al: The spectrum of neuroendocrine tumors: histologic classification, unique features and areas of overlap. Am Soc Clin Oncol Educ Book. 35:92-103, 2015
- Carter BW et al: Small cell lung carcinoma: staging, imaging, and treatment considerations. Radiographics. 34(6):1707-21, 2014
- Benson RE et al: Spectrum of pulmonary neuroendocrine proliferations and neoplasms. Radiographics. 33(6):1631-49, 2013
- Lu HY et al: Targeted therapies in small cell lung cancer. Oncol Lett. 5(1):3-11, 2013
- Gaspar LE et al: Small-cell lung cancer: prognostic factors and changing treatment over 15 years. Clin Lung Cancer. 13(2):115-22, 2012
- Kalemkerian GP: Staging and imaging of small cell lung cancer. Cancer Imaging. 11:253-8, 2012
- Travis WD: Advances in neuroendocrine lung tumors. Ann Oncol. 21 Suppl 7:vii65-71, 2010
- Vallières E et al: The IASLC Lung Cancer Staging Project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 4(9):1049-59, 2009
- Franks TJ et al: Lung tumors with neuroendocrine morphology: essential radiologic and pathologic features. Arch Pathol Lab Med. 132(7):1055-61, 2008
- Chong S et al: Neuroendocrine tumors of the lung: clinical, pathologic, and imaging findings. Radiographics. 26(1):41-57; discussion 57-8, 2006
