Small cell neuroendocrine carcinoma is a type of undifferentiated, malignant neuroendocrine tumor. Most of neuroendocrine tumors exhibit well-differentiated features and are classified as carcinoid tumors. However, carcinomas of the liver with anaplastic characters, which are classified as small-cell carcinomas are extremely rare and only few cases have been reported in the literature. We report an unusual case of primary small cell neuroendocrine carcinoma of the liver in a 67-year-old man. The patient was found to have a palpable mass on right upper quadrant of abdomen on physical examination. The diagnosis was made by immunohistochemical stains of biopsied specimen from the liver. Other possible primary site was excluded by radiologic and endoscopic evaluations. The tumor was composed of small monotonous and hyperchromatic poorly differentiated cells with higher nuclear to cytoplasmic ratio, and were positive for neuroendocrine tissue markers such as synaptophysin, c-kit, and CD56.
Aged ; Carcinoma, Neuroendocrine/*diagnosis/pathology ; Carcinoma, Small Cell/*diagnosis/pathology ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Male

Adult ; Carcinoma, Small Cell ; diagnosis ; pathology ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; pathology ; Male

Biopsy, Fine-Needle ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; pathology ; Humans ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; diagnosis ; pathology ; Small Cell Lung Carcinoma ; diagnosis ; pathology

BACKGROUND: Review of the outside pathology material is an important practice that provides useful information on patient managements and improves the diagnostic quality in surgical pathology. We report our experience with the frequency and types of diagnostic discrepancies in patients referred to the Asan Medical Center for treatment or a second opinion. METHODS: All referral pathology diagnoses (867 surgical cases) made from October 2001 to July 2002 at Asan Medical Center were compared with outside pathology diagnoses. RESULTS: Of the 867 surgical cases reviewed, 231 (26.7%) cases had a diagnostic discrepancy, which included 49 (5.7%) major and 182 (21.0%) minor discrepancies. The contents of the major discrepancies were a change in the diagnosis (34 cases), a change in the type of malignancy including small cell carcinoma and non-small cell carcinoma of the lung (10), a diagnosis of a metastasis as the primary lesion (4), and errors in interpreting the invasiveness (1). The causes or reasons for the major discrepancy were a difference in interpretation (81.6%), the availability of special studies (10.2%), a failure to identify the lesions (4.1%), and a lack of clinical information (4.1%). CONCLUSIONS: The major discrepancy rate (5.7%) was comparable to that of the other reports from western countries. Among the major discrepancies, a change in diagnosis was most commonly observed and difference in interpretation was the most common reason. A routine review of all the patients pathology material is recommended for all referral patients for an improvement in the pathologic diagnoses and to provide better medical care.
Carcinoma, Small Cell ; Chungcheongnam-do* ; Diagnosis ; Humans ; Lung ; Neoplasm Metastasis ; Pathology ; Pathology, Surgical* ; Referral and Consultation*

Carcinoma, Small Cell ; diagnosis ; Diagnostic Errors ; Humans ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology

Intramedullary spinal cord metastasis is rare, but is being encountered with increasing frequency with the availability of more sensitive imaging techniques. RI is the most sensitive of these techniques, though it cannot differentiate between intramedullary spinal cord metastasis and other cord pathologies. Occasionally, therefore, surgical biopsy is indicated though optimal treatment after diagnosis remains controversial. Radical resection, radiation and chemotherapy significantly prolong survival, but many patients survive less than one year. The authors have encountered two cases of intramedullary spinal cord metastasis of small cell carcinoma of the lung. These are reviewed, together with literature describing adequate evaluation and management.
Biopsy ; Carcinoma, Small Cell ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Neoplasm Metastasis* ; Pathology ; Spinal Cord*

Humans ; Consensus ; Lung Neoplasms/pathology* ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Biopsy

In recent years, series of driver genes, such as EGFR, KRAS/NRAS, BRAF, PIK3CA, ALK and ROS1 and so on, have been found in non-small cell lung cancer (NSCLC) one after another with the development of molecular detecting technology. Targeted drugs bring benefits for these NSCLC patients with driver gene variations. However, some NSCLC did not have any known driver gene variations; we called it pan-negative lung cancer. In this paper, we summarize the concept, clinical pathological characteristics, the epidemiological characteristics, treatment and prognosis of pan-negative NSCLC.
Carcinoma, Non-Small-Cell Lung ; diagnosis ; drug therapy ; genetics ; pathology ; Humans ; Lung Neoplasms ; diagnosis ; drug therapy ; genetics ; pathology ; Mutation ; Prognosis

Adenocarcinoma ; pathology ; Carcinoma, Small Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Diagnosis, Differential ; Humans ; Lung Neoplasms ; classification ; genetics ; pathology ; World Health Organization

OBJECTIVETo evaluate the role of transbronchial needle aspiraion (TBNA) in the diagnosis of bronchogenic carcinoma with enlarged mediastinal and/or hilar lymph node.

METHODSPatients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported by WANG. All specimen was directly and instantly smeared for cytological examination.

RESULTSFrom June 2004 to May 2006, 77 such patients were examined: including 38 lung cancers, 35 lung benign diseases and 4 without definite diagnosis. All TBNA procedures were successfully carried out in 222/225 ( 98.7%). Positive TBNA rate was 81.6% (31/38) in patients who had been proven to suffer from bronchogenic carcinoma. The diagnosis of lung cancer was confirmed via TBNA only in 9 patients. A total of 63 lymph nodes in the 38 lung cancer patients were aspirated by TBNA with a positive rate of 65.1% (41/63). The sensitivity of TBNA was significantly correlated with pathology type, lymph node size and experience of the cytologist. Severe complications were rare except small amount of bleeding at the TBNA site (52/77, 67.5%).

CONCLUSIONTBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, yet it is not helpful in diagnosis of benign lung diseases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Bronchoscopy ; Carcinoma, Bronchogenic ; pathology ; Carcinoma, Non-Small-Cell Lung ; pathology ; Carcinoma, Small Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; pathology ; Lymph Nodes ; pathology ; Male ; Mediastinum ; Middle Aged ; Reproducibility of Results