CASE N°29 – Pulmonary Small Cell Carcinoma

Clinical History:

Age: 63

Sex: Male

Cough, fever.  Tac-Scan: multiple pulomonary nodules (0,5-1 cm. max). Hilar and mediastinal adenopathy.

Cytological Images:

Cytological speciemen: Trans-Bronchial FNA from mediastinal adenopathy

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24111328

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Cytological Report:

Malignant cells: small cell size with scant cytoplasm and finely granular chromatin pattern. Presence of mitosis e necrosis. Pulmonary small cell carcinoma metastases.

Histological Images:

Histological speciemen: Trans-Bronchial Biopsy from mediastinal adenopathy

ee1 h/e

ee2 h/e

CKpool CK-Pool

Ki67 CD56

CD56 MIB1

Synapto Synaptofisin

Histological Report:

Poorly differentiated carcinoma with features related to neuroendocrine carcinoma with small cell aspects.
Immunophenotype: CKpool + (dot), CD56 +, Synaptophysin +.
Proliferation index (MIB1) about 90%.

Discussion:

The small cell carcinoma of the lung is characterized by the presence of small cells with scant cytoplasm, finely granular chromatin, nuclear moulding, often accompanied by the presence of mitotic figures and necrotic background. As in this case, the biopsy is characterized by CKpool (dot) pattern,  positivity to neuroendocrine markers and very high proliferation index.

Tips:

Compare the small cell carcinoma cyto-morphology pattern with this one from pulmonary carcinoid tumor  

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