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Case 66

A 64 year old female with history of papillary thyroid carcinoma who was found to have a 3.4 cm lung nodule.


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  1. What's your interpretation?

    A: metastatic PTC

    B:Basaloid SCC

    C: Typical carcinoid

    D: Atypical carcinoid

    E: Neuroendocrine carcinoma


Answer

Although the final thoughts need stain, but by morphology, this is in the realm of neuroendocrine morphology. Tumor cells are positive for TTF1 and synaptophysin; negative for P40, calcitonin, Pax8 and NapsinA. Ki-67 shows focally up to 20% proliferation index. There are 2-3 mitosis/2 mm2 identified. Focal puncated necrosis are seen. Overall findings are consistent with atypical carcinoid. The correct answer is E.

Case credit: UCSD Pathology

Author: Wangpan Shi, MD

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