Bronchial carcinoid tumors with massive osseous metaplasia: a case report and review of the literature

Abstract

Bronchial carcinoid tumors are primary lung neoplasms thought to originate from neuroendocrine cells, i.e. Kulchitsky cells, in the bronchial mucosa, although the type of cellular origin has not been clearly understood. A 61-year-old male patient underwent surgery and microscopic examination of the specimen revealed an anastomosing trabecular bony structure among the nests of tumor cells with round nucleus, granular chromatin, and large eosinophilic cytoplasm. Our case has been deemed worthy of being presented as bronchial carcinoid tumor with exaggerated osseous metaplasia.

Metaplasia ósea en pulmón y enfisema pulmonar en un individuo sano con tos crónica y pérdida de peso

“…Los tumores carcinoides, bronquiales o pulmonares pueden asociarse a focos de metaplasia ósea y/o a zonas de calcificación. 5 Hasta 30% de dichos casos muestran osificación en el estroma vascular adyacente a la masa tumoral, y sólo 10% puede mostrar focos de osificación intratumoral. 6 En nuestro caso, no se observó una masa tumoral asociada a las zonas de metaplasia ósea.…”

Diagnostic Approaches to Neuroendocrine Neoplasms of Unknown Primary Site

“…19 In addition, clues about the primary tumor site in NETs-UP could be obtained using hematoxylin and eosin stain; for instance, amyloid deposits suggest medullary thyroid carcinoma, and stromal ossification may suggest pulmonary origin. [21][22][23] However, these findings are not specific and could be seen with other NETs; thus, they should be used in conjunction with different diagnostic approaches. Table 2 shows NETs' commonly associated growth patterns and histological features.…”

“…Basophilic and granular cytoplasm may suggest metastasizing pheochromocytoma or abdominal paragangliomas, in contrast to the more amphophilic nature of the rest of the NETs 19 . In addition, clues about the primary tumor site in NETs-UP could be obtained using hematoxylin and eosin stain; for instance, amyloid deposits suggest medullary thyroid carcinoma, and stromal ossification may suggest pulmonary origin 21–23 . However, these findings are not specific and could be seen with other NETs; thus, they should be used in conjunction with different diagnostic approaches.…”

Metastatic Neuroendocrine Neoplasms of Unknown Primary: Clues from Pathology Workup

“…There might also be additional site-specific hints waiting to be discovered in hematoxylineosin-stained preparations; for example, stromal ossification may suggest a lung primary, although this phenomenon has also been reported in NENs of extrapulmonary origin [27]. Similarly, amyloid deposits should raise the suspicion of medullary thyroid carcinoma (MTC), and the amyloid could be verified using a Congo Red stain [28].…”