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VOLUME 9 , ISSUE 1 ( January-June, 2020 ) > List of Articles


Large Cell Neuroendocrine Tumor of the Lung: A Diagnostic Challenge

Jayasri Helen Gali, Harsha Vardhana Varma

Keywords : Immunohistochemistry, large cell neuroendocrine tumor, lung neuroendocrine tumor

Citation Information : Gali JH, Varma HV. Large Cell Neuroendocrine Tumor of the Lung: A Diagnostic Challenge. Indian J Respir Care 2020; 9 (1):97-99.

DOI: 10.4103/ijrc.ijrc_7_19

License: CC BY-NC-SA 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2020; Indian Journal of Respiratory Care.


Lung neuroendocrine carcinoma (NEC) is a rare heterogeneous carcinoma with NE cells in the pulmonary and bronchial epithelium as the site of origin. We describe a case of large cell NEC (LCNEC) in a 55-year-old male, smoker with 25 pack-years, who presented with cough, dyspnea, hemoptysis, and loss of appetite for 6 months. There was no diabetes, hypertension, asthma, chronic obstructive pulmonary disease, tuberculosis, or contact with tuberculosis or malignancy. The presence of a large homogenous mass lesion in the right chest on chest X-ray, further clearly defined on chest computed tomography scan (130/94/123 mm) was suggestive of huge mass. There was no mediastinal or pleural involvement. Possibility of LCNEC was suspected as the ultrasound-guided biopsy was indicating the presence of poorly differentiated carcinoma. Immunohistochemistry was negative for thyroid transcription factor, cytokeratin 7 but was positive for synaptophysin and P40, suggestive of high-grade LCNECs. It was in T4N0M0, stage 3A and treatment with combination chemotherapy was initiated.

  1. Fasano M, Della Corte CM, Papaccio F, Ciardiello F, Morgillo F. Pulmonary large-cell neuroendocrine carcinoma: From epidemiology to therapy. J Thorac Oncol 2015;10:1133-41.
  2. Arrigoni MG, Woolner LB, Bernatz PE. Atypical carcinoid tumors of the lung. J Thorac Cardiovasc Surg 1972;64:413-21.
  3. Travis WD, Linnoila RI, Tsokos MG, Hitchcock CL, Cutler GB Jr., Nieman L, et al. Neuroendocrine tumors of the lung with proposed criteria for large-cell neuroendocrine carcinoma. An ultrastructural, immunohistochemical, and flow cytometric study of 35 cases. Am J Surg Pathol 1991;15:529-53.
  4. Amirtham U, Mulchandani NJ, Premalata CS, Bharatnur SA, Kumar RV. Spectrum of primary pulmonary neuroendocrine tumors from a regional cancer centre in South India. J Med Sci Clin Res 2017;5:24997-5002.
  5. Mohapatra P, Patra S, Bhuniya S, Panigrahi M, Mishra P, Purkait S, et al. Pulmonary large cell neuroendocrine carcinoma (LCNEC): An experience from Eastern Indian hospital. J Thorac Oncol 2017;12:S2183-4.
  6. Battafarano RJ, Fernandez FG, Ritter J, Meyers BF, Guthrie TJ, Cooper JD, et al. Large cell neuroendocrine carcinoma: An aggressive form of non-small cell lung cancer. J Thorac Cardiovasc Surg 2005;130:166-72.
  7. Iyoda A, Hiroshima K, Nakatani Y, Fujisawa T. Pulmonary large cell neuroendocrine carcinoma: Its place in the spectrum of pulmonary carcinoma. Ann Thorac Surg 2007;84:702-7.
  8. Takei H, Asamura H, Maeshima A, Suzuki K, Kondo H, Niki T, et al. Large cell neuroendocrine carcinoma of the lung: A clinicopathologic study of eighty-seven cases. J Thorac Cardiovasc Surg 2002;124:285-92.
  9. Hiroshima K, Mino-Kenudson M. Update on large cell neuroendocrine carcinoma. Transl Lung Cancer Res 2017;6:530-9.
  10. Naidoo J, Santos-Zabala ML, Iyriboz T, Woo KM, Sima CS, Fiore JJ, et al. Large cell neuroendocrine carcinoma of the lung: Clinico-pathologic features, treatment, and outcomes. Clin Lung Cancer 2016;17:e121-9.
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