Bronchial carcinoids

Abstract

“ External radiotherapy is otherwise used only against brain metastases or for pain relief in patients with bone metastases. There are no studies showing that adjuvant therapy is beneficial after radical surgery. ” Bronchial neuroendocrine tumors are subdivided into typical carcinoids, atypical carcinoids, large cell neuroendocrine carcinomas and small-cell lung carcinomas. Large-cell neuroendocrine carcinomas as well as small-cell lung carcimomas are highly malignant tumors with a poor prognosis. Smoking is a major etiological factor. These patients are principally treated by chemotherapy and radiotherapy. In addition, surgery may have some place in the treatment of large-cell neuroendocrine carcinomas. These two tumor types will not be further discussed in this article, which will focus on typical and atypical carcinoids. In addition, two other entities will be briefly mentioned, namely tumorlets and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, DIPNECH. Gastroenteropancreatic neuroendocrine tumors are classified according to mitotic count and proliferative rate (Ki67 index) into neuroendocrine tumor grade 1, neuroendocrine tumor grade 2 and neuroendocrine carcinoma grade 3, small and large cell, respectively. The classification of neuroendocrine lung neoplasms, however, is still based on mitotic count. Typical carcinoids have less than two mitoses per 2 mm 2 (ten high-power fields) while atypical carcinoids have between two and ten mitoses per 2 mm 2 . Atypical carcinoids may contain