A 55-year-old man presented with a metastasizing moderately differentiated neuroendocrine carcinoma of the larynx (atypical carcinoid). Immunocytochemical demonstration of neuroendocrine markers (neuron-specific enolase and chromogranin-A) and presence of membrane-bound neurosecretory granules in the cells established the neuroendocrine nature of the tumour. In addition, the tumour was found to produce calcitonin, somatostatin and carcino-embryonic antigen (CEA). Calcitonin and somatostatin were also secreted. On the basis of this particular marker constellation the tumour closely resembles medullary thyroid carcinoma. Review of the recent literature on carcinoids of the larynx reveals immunoreactivity for calcitonin and CEA in a high percentage of cases.
A patient presented with the clinical and laboratory features of the ectopic ACTH syndrome. No ACTH-producing tumor was found, and bilateral adrenalectomy was performed to correct the hypercortisolism. Six months later, the removal of a pseudotumor containing only fat and inflammatory tissue resulted in normalization of both basal plasma ACTH levels and the ACTH feedback response to cortisol infusion. It is suggested that the leukocytes in the inflammatory tissue were the source of the ectopic ACTH production.
Intravascular bronchioloalveolar tumor (IV-BAT) is a recently described, histologically distinct, malignant, primary lung neoplasm. Originally it was believed to arise from type II alveolar cells which invade blood vessels within the lung, and hence its name. More recent ultrastructural studies suggest an origin from mesenchymal cells, and therefore the tumor may be more appropriately considered a sarcoma. The onset of the disease may be insidious, and its clinical course may vary from slow to rapid progression. A history is presented of a young woman with slowly enlarging multiple ill defined pulmonary nodules. Open lung biopsy was diagnostic of IV-BAT. The clinical course, differential diagnosis and pathogenesis of this tumor are briefly discussed.
We present a case of Langerhans' cell histiocytosis (LCH) of the liver and spleen in an adult. The imaging features are different from those in the few previously reported cases of individual organ involvement by LCH.
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