Trachea - Small cell carcinoma

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Trachea

Tumors

Small cell carcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 3 February 2013, last major update October 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Histology similar to bronchial tumor
● 6% of primary tracheal tumors in 1993 study (Thorax 1993;48:688)

Clinical features
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● Endotracheal nodule or eccentric wall thickening, papillomatous at endoscopy
● May be tracheobronchic
● May occur with hypophosphatemia osteomalacia and Cushing syndrome
● May occur secondary to breast ductal carcinoma with radiation, or be metastatic from lung primary
● May metastasize to CNS

Case reports
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● 25 year old woman with central airway obstruction and dyspnea (Br J Radiol 2008;81:e120)
● 27 year old man (Rev Pneumol Clin 1994;50:172)
● 42 year old woman with multiple papillomatous-like tumors involving trachea and bronchi. (Chest 1983;83:817)
● 58 year old woman with ankle swelling, dysphagia, widespread bone and joint pains and hypophosphataemia (J Clin Pathol 1994;47:80)
● 60 year old man with dyspnea on exertion and faint stridor (Thorax 1980;35:72)
● Ultrastructural evidence of endocrine differentiation (Arch Pathol Lab Med 1984;108:149)

Treatment
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● Radio-chemotherapy (Presse Med 1992;21:1905)

Micro description
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● Classic features of large neuroendocrine cells with high N/C ratio, hyperchromatic nuclei, crush artifact, nuclear molding
● May show combined morphology with squamous cell carcinoma and giant cell carcinoma

Micro images
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Small clusters and rosettes of small tumour cells

Adjacent islands of oat cell and squamous cell carcinoma surrounded by stroma containing bizarre giant cells (Haematoxylin and eosin X500)

Esophagus: small cell carcinoma, oat cell type

Positive stains
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● Keratin; also bombesin and CEA

Differential diagnosis
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● Extension from bronchial tumor

End of Trachea > Tumors > Small cell carcinoma

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