Pulmonary tumourlets are focal aggregates of neuroendocrine cells that occur in the periphery of the lung and may be associated with chronic inflammation and scarring. Six such lesions were seen in five lungs from a series of 35 pairs of lungs studied at necropsy.
MethodsTumourlets were sought in the lungs of 35 patients coming to necropsy, the only criterion for selection being that the necropsy was performed within 48 hours of death. In each case the left lung was distended with Bouin's solution, allowed to fix for 48 hours, and cut into 1 cm sagittal slices. At least 12 random blocks were then taken from each, a numbered perspex grid being placed over each slice, and a table of random numbers being used to select the blocks, with the proviso that large airways and vessels were avoided. Multiple blocks were taken from the non-distended right lungs at the time of the necropsy and these were also fixed in Bouin's solution for 48 hours. After being embedded in paraffin wax sections were stained with haematoxylin and eosin and the elastic van Gieson method and examined by light microscopy.When a tumourlet was discovered, serial sections of the block in which it was contained were cut and immunochemically labelled for neurone specific enolase and protein gene product 9 5, markers of pulmonary neuroendocrine cells,67 and a series of products of neuroendocrine cells (table 1) by the peroxidase-antiperoxidase technique.8 These substances were chosen for study because either they are found in the neuroendocrine cells of the normal human lung (gastrin releasing peptide, calcitonin, leucineenkephalin, and 5-hydroxytryptamine)9"' or