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[Multifocal Pulmonary Neuroendocrine Tumours: Genesis, Diagnostics and Treatment]
A Kirschbaum1, B Beutel2, A Rinke3
1Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Uniklinik Gießen und Marburg (UKGM), Standort Marburg.
Pneumologie (Stuttgart, Germany)
|February 20, 2016
Summary
Multifocal neuroendocrine lung tumors, a rare condition, arise from diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. Early diagnosis and small tumor size (<5mm) without symptoms correlate with a favorable prognosis and over 90% 5-year survival.
Area of Science:
- Pulmonology
- Oncology
- Pathology
Background:
- Multifocal neuroendocrine lung tumors are rare, often diagnosed incidentally on chest CT scans.
- They are believed to originate from diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH).
- Tumorlets (≤5 mm) and carcinoid tumors (>5 mm) arise from proliferating neuroendocrine cells.
Purpose of the Study:
- To describe the characteristics of multifocal neuroendocrine lung tumors.
- To outline a stepwise treatment approach based on clinical and HRCT findings.
- To report prognostic factors and survival rates.
Main Methods:
- Review of clinical presentations and high-resolution computed tomography (HRCT) findings.
- Diagnostic gold standard: surgical lung biopsy with histological examination.
- Development of a stepwise therapeutic strategy guided by treatment outcomes.
Main Results:
- Many patients are asymptomatic; others present with dyspnea, reduced capacity, or cough, potentially with reduced lung function.
- HRCT may show peribronchial fibrosis or bronchiectasis alongside lung foci.
- Histology reveals a mix of cell hyperplasias, tumorlets, and carcinoid tumors.
Conclusions:
- There is no established consensus on the treatment of multifocal neuroendocrine lung tumors.
- A stepwise approach tailored to clinical status and HRCT findings is proposed.
- Asymptomatic patients with foci <5 mm have an excellent prognosis with >90% 5-year survival.
